The Effects of Exercise Cardiac Rehabilitation on Anxiety, Depression and Quality of Life in Coronary Artery Bypass Grafting Patients

Introduction & Despite advancement in technology such as coronary artery bypasses grafting (CABG) prevalence of anxiety and depression remain high after cardiac events, which have been found to influence recovery process, recurrent cardiac events and patients’ quality of life. Cardiac Rehabilitation (CR) as part of secondary prevention aims to improve patients’ physical, psychological and quality of life (QoL) status. As there is lack of study in this area in Iran, the present study aim to investigate the effects of a 12 week exercise CR on anxiety, depression and quality of life in the Iranian CABG patients. In this cross sectional study 72 consecutive CABG patients referred to and enrolled in a 12 week (3 session per week) CR program in rehabilitation center of Shahid Beheshti hospital of Hamadan(Iran). 60 patients completed and 12(17%) dropped out of the program. Patients underwent exercise testing using modified Bruce protocol before and immediately after CR. Initial exercise intensity was 45-55% of VO2 peak(peak of oxygen consumption) which was progressively increased to 0.5 MET (metabolic equivalent unit) per week to 70-85%. Patients also completed the quality of life questionnaire and hospital anxiety and depression scale (HADs) at each time point. Compared with pre CR exercise capacity, MET and BMI statistically improved after the program (P<0.001). The prevalence rate of anxiety and depression preprogram were 31.6% and 25% which statistically reduced post CR(11.6% and 8.4%). Further analysis indicated a significant improvement in all components of QoL (physical, mental and social) similarly in men and women after the program. Additionally men and women did benefit from CR program similarly as there were no significant differences between men and women in terms of improvements in anxiety, depression and quality of life after the program. It is concluded that the completion of a CR program has beneficial effects on physical and psychological status of CABG patients. As the findings indicate similar effects of CR program in both men and women,it is suggested to refer all CABG patients especially women to CR program regardless of sex.