Use and effects of cardiac rehabilitation in patients with coronary heart disease: results from the EUROASPIRE III survey.
OBJECTIVE
To describe lifestyle and risk-factor management in patients attending cardiac rehabilitation programmes (CRPs) compared to those who do not.


METHODS
A cross-sectional survey.


METHODS
The EUROASPIRE III survey was conducted in 76 centres in 22 European countries. Consecutive patients having had a coronary event or revascularization before the age of 80 were identified and interviewed at least 6 months after hospital admission.


RESULTS
13,935 medical records were reviewed and 8845 patients interviewed (participation rate 73%); 44.8% of patients reported being advised to attend a CRP and of these 81.4% did so (36.5% of all patients). There were wide variations between countries and diagnostic categories, ranging from 15.9% in the Ischaemia group to 68.1% in the CABG group. Characteristics associated with participation in a CRP included younger age, male sex, higher educational level and CABG as a recruiting index event, while smokers were less likely to attend a CRP. Patients who attended a CRP had a significantly lower prevalence of smoking, better control of total and LDL-cholesterol and higher use of beta-blockers, ACE inhibitors/ARBs and lipid-lowering drugs.


CONCLUSIONS
CRPs in Europe are underused, with poor referral and low participation rate and wide variations between countries. Despite this heterogeneity, the control of smoking and cholesterol and the use of cardioprotective medication is better in those who attend a CPR. There is an urgent need for comprehensive, multidisciplinary rehabilitation programmes to integrate professional lifestyle interventions with effective risk-factor management, appropriately adapted to the medical, cultural and economic settings of a country.
Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
Kornelia
K
Kotseva
David
D
Wood
Guy
G
De Backer
Dirk
D
De Bacquer
D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016540:Smoking Cessation; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D000960:Hypolipidemic Agents