PHYSICAL AND PSYCHOSOCIAL EFFECTS OF CARDIAC REHABILITATION PARTICIPATION IN PATIENTS WITH AND THOSE WITHOUT CORONARY ARTERY DISEASE AND WOMEN COMPARED TO MEN
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Yassin, Ihab Mohamed Samir
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Yassin, Ihab Mohamed Samir. 2022. PHYSICAL AND PSYCHOSOCIAL EFFECTS OF CARDIAC REHABILITATION PARTICIPATION IN PATIENTS WITH AND THOSE WITHOUT CORONARY ARTERY DISEASE AND WOMEN COMPARED TO MEN. Master's thesis, Harvard Medical School.Abstract
Two -thematically similar- studies addressing two less studied groups of patients (women, and those referred for non-coronary artery disease (non-CAD)) in cardiac rehabilitation (CR) programs. Common research question was to assess CR benefits in these groups compared to men and those referred for coronary artery disease (CAD). The primary aim of the first study was to evaluate and compare exercise capacity and psychological well-being between patients referred to CR for CAD diagnoses and those for non-CAD diagnoses. We sought in the second study to demonstrate whether women enrolled in a contemporary CR program derived similar benefits as men.Primary endpoint was improvement in 6-minute walking distance (6MWD). Secondary endpoints included change in proportion of patients exercising more than 150 minutes per week (≥150 minutes/week) (EMW150), depression scores (PHQ9), anxiety scores (GAD7) and overall quality of life (COOP) scores.
Between January 2015 and February 2020, 617 patients (26% women) completed the 12-week-CR program and were divided into: group I (referred for non-CAD diagnosis) (N=188) and group II (referred for CAD diagnosis) (N=429). At the completion of their cardiac rehabilitation program, both groups improved their 6MWD without statistical difference (non-CAD group: +188 (110, 274) feet) vs. +200 (89, 290) feet in CAD group, P=0.86).
By the end of the CR program, women had similar improvement in their 6MWD as men (women: median (IQR): 14 [7, 20] % (increase from baseline) vs. men: 13[6, 21] % (increase from baseline), p-value=0.87). Women with mild anxiety improved significantly more than men.
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