title: Impact of cardiac rehabilitation on quality of life and depression after acute coronary syndrome.
abstract: OBJECTIVE
  To evaluate the impact of cardiac rehabilitation programs (CRP) on quality of life (QL) and depression at one-year follow-up after acute coronary syndrome (ACS).
  
  
  METHODS
  Two hundred and three patients, without previous cardiological follow-up and referred to the outpatient clinic after hospitalization for ACS between 9/1/2001 and 12/31/2002, were randomly allocated to a 12-week, 3-times-a-week CRP or standard cardiology follow-up only, after giving their informed consent. Baseline population characteristics were recorded and, in patients with more than 4 years' education, QL and depression were evaluated during hospitalization and at one-year follow-up by self-reported responses to the SF-36 QL survey and the Beck Depression Inventory (BDI) respectively. Analysis was by intention-to-treat.
  
  
  RESULTS
  31 patients randomized to CRP, mean age 56 years (31-80), 84% male (group A) and 95 patients, mean age 58 years (33-86), 83 % male, allocated to standard follow-up (group B), responded to the questionnaires. There were no significant differences between the two groups in any of the variables evaluated by the questionnaires during hospitalization. At one-year evaluation, the average BDI score was lower in the CRP group (8 vs. 11, p = 0.05). The prevalence of depressive symptoms (37.5 vs. 56.1%) or severe depression (3.1% vs. 12.2%) was also lower, in this group, although not significantly. SF-36 found significant differences in the evaluation of Vitality (average 62 points in A vs. 47 in B, p < 0.02) and General Health (57 points in A vs. 46 points in B, p < 0.02); there were no differences in the other parameters evaluated. When the physical and mental health components were analyzed, a significant difference favoring CRP was found in mental health (70.6 vs. 56.9, p = 0.02) but not in physical health (62.9 in A vs. 56.4 in B, NS).
  
  
  CONCLUSIONS
  Despite the small sample size, significant differences favorable to CRP after ACS were found. After one-year follow-up, patients referred to CRP have a better BDI score; the Vitality and General Health parameters, as well as the mental health component evaluated by SF-36, are also significantly improved after CRP.
authors.affiliation: Serviço de Cardiologia do Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal. nunobett@netcabo.pt
authors.forename: Nuno
authors.initials: N
authors.lastname: Bettencourt
authors.forename: Carla
authors.initials: C
authors.lastname: Dias
authors.forename: Pedro
authors.initials: P
authors.lastname: Mateus
authors.forename: Francisco
authors.initials: F
authors.lastname: Sampaio
authors.forename: Lino
authors.initials: L
authors.lastname: Santos
authors.forename: Luís
authors.initials: L
authors.lastname: Adão
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateus
authors.forename: Nuno
authors.initials: N
authors.lastname: Salomé
authors.forename: Fátima
authors.initials: F
authors.lastname: Miranda
authors.forename: Madalena
authors.initials: M
authors.lastname: Teixeira
authors.forename: Lino
authors.initials: L
authors.lastname: Simões
authors.forename: Vasco Gama
authors.initials: VG
authors.lastname: Ribeiro
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013577:Syndrome