Researchers Identify Factors That May Keep Some Patients From Making Optimal Gains in Cardiac Rehab

Authors of a new study say they’ve found a set of predictors that could help providers identify which cardiac rehabilitation (CR) patients are at risk of making lower gains in exercise capacity (EC) from the intervention.

Researchers analyzed before-and-after results from the 6-minute walk test (6MWT) among 541 patients enrolled in the Mayo Clinic Florida’s CR program, tracking distance as well as heart rate and blood pressure before and after each test. Next they compared post-CR 6MWT results with a range of health and demographic data including type of initial cardiac procedure, age, sex, body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (LDL), triglycerides, and use of lipid-lowering drugs (LLD) at baseline. Results were published in the American Journal of Cardiology.

When they looked at who didn’t achieve optimal EC after CR, researchers found a constellation of factors that they believe may be predictive of an individual’s likelihood of making substandard gains. In all, 9 major predictors were identified (listed here in descending order of effect): baseline distance on 6MWT, age, percutaneous coronary intervention (or PCI, as opposed to coronary artery bypass graft, or CABG), LDL-C level, gender, the interaction of LDL-C while on LLDs, systolic BP at rest, BMI, and triglyceride levels.

Full story of key factors identified that prevent gains in cardiac rehab at APTA

Researchers Say Cardiac Rehab Not Reaching Enough People

Even though cardiac rehabilitation (CR) is strongly supported as an intervention for patients who have suffered a heart attack, too few people are getting referrals for CR programs, and an even smaller number is actually following through once they get a referral, according to a research letter recently published in JAMA.

Authors looked at CR enrollment and participation rates by comparing Medicare records of 58,269 acute myocardial infarction (AMI) patients with a national registry of coronary treatment intervention outcomes (National Cardiovascular Data Registry Acute Coronary Treatment Intervention Outcomes Registry). They found that between 2007 and 2010, only 64.2% of AMI patients were referred to CR at the time of hospital discharge, and only 12,000 of those patients attended at least 1 CR session during the following year.

Broken down in another way, the rates of CR referral and engagement are even more disappointing: according to the researchers, among all patients included in the study, only 23.1% attended at least 1 CR session. Just 5.4% completed 36 sessions or more—the number of sessions typically covered by health insurance.

Full story of not enough people getting cardiac rehab at APTA

Move Forward Radio Discusses Heart Health and Cardiac Rehab for American Heart Month

Knowing the signs of heart attack is important, but just as important are understanding the risk factors for heart disease and making the lifestyle changes that can reduce those risks. That’s the focus of a recent Move Forward Radio episode that addresses heart health issues and the role of a physical therapist.

In recognition of February as American Heart Month, Move Forward Radio talks with Pamela Bartlo, PT, DPT, CCS, who outlines the signs of a heart attack and risk behaviors for heart disease. She also describes the role of a PT in cardiac rehabilitation, and discusses how cardiac rehabilitation works best as a part of a lifestyle change for people who have heart issues.

Full story of heart health and cardiac rehab at APTA