Circ: Cardiac rehab programs boosts post-PCI survival by 50%

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Patients who undergo cardiac rehabilitation programs post-PCI have a 50 percent greater chance of long-term survival, according to a study published in the May 16 issue of Circulation: Journal of the American Heart Association.

Randal Thomas, MD, principal investigator of the study and director of the Mayo Clinic’s Cardiovascular Health Clinic in Rochester, Minn., performed a 14-year analysis evaluating patients treated with PCI at Mayo between 1994 and 2008.

The study included 2,400 patients who underwent PCI and telephone follow-up. The researchers evaluated outcomes. Forty percent of patients participated in at least one cardiac rehabilitation session after PCI. The average number of sessions attended was 13.5.

“Such programs can boost survival rates after heart attacks and systematically provide lifestyle interventions and treatments to improve recovery and long-term health of heart patients,” the authors wrote.

The researchers also looked at smoking status, obesity, high cholesterol, family history and medical conditions that had the potential to affect life expectancy (heart failure, kidney disease or diabetes). Four hundred patients experienced an MI post-PCI and 755 had to undergo additional procedures to unblock vessels. The researchers reported 503 deaths; 199 were cardiac-related.

The authors noted that cardiac rehabilitation programs can include patient education, monitored and personalized exercise training, nutrition counseling, smoking cessation support, weight control and medical evaluations.

“Cardiac rehabilitation programs are effective at improving recovery, quality of life and long-term survival because they help deliver the lifestyle and medication therapies that have been shown to slow or even reverse the process of heart disease,” Thomas said.

American College of Cardiology (ACC), American Heart Association (AHA) and Society for Cardiovascular Angiography and Interventions (SCAI) guidelines recommend cardiac rehabilitation post-PCI; however, only one-quarter of eligible patients participate in such programs.

“Gains in long-term survival would be substantial if all eligible PCI patients received cardiac rehabilitation,” Thomas said.

The researchers said that on average, most insurance companies will cover up to 36 session of cardiac rehabilitation after PCI or MI. Medicare typically covers 80 percent of these costs. Thomas and colleagues concluded that while participation in cardiac rehabilitation programs has increased, most patients and doctors remain unaware that these types of programs are covered by insurance.