title: Cardiac Rehabilitation Prevents Recurrent Revascularization in Patients With Coronary Heart Disease: A POPULATION-BASED COHORT STUDY IN TAIWAN.
abstract: OBJECTIVE
  To evaluate the effects of cardiac rehabilitation (CR) provided within the first 3 months of revascularization on reducing recurrent revascularization in patients with coronary heart disease in Taiwan.
  
  
  METHODS
  In this population-based cohort study, we used the claims data of 1 million beneficiaries who were randomly selected from all beneficiaries enrolled in Taiwan's National Health Insurance program from 1996 to 2000. Between 2000 and 2007, 2838 patients underwent a first-event revascularization. Of these patients, 442 (15.6%) underwent CR within the first 3 months of admission for revascularization. The remaining 84.4% (n = 2396) served as the non-CR group. All the study patients were followed-up until the end of 2008 for any recurrent revascularization. A propensity score-adjusted Cox proportional hazard model was used to estimate the relative risk of recurrent revascularization associated with CR.
  
  
  RESULTS
  During the 1- to 9-year follow-up, 69 patients (15.6%) in the CR group and 840 (35.1%) patients in the non-CR group experienced recurrent revascularization. The results of the propensity score-adjusted Cox proportional hazard regression analysis showed that CR was significantly associated with a reduced risk of recurrent revascularization with a hazard ratio of 0.48 (95% CI, 0.37 to -0.62).
  
  
  CONCLUSIONS
  Cardiac rehabilitation within the first 3 months of revascularization is significantly associated with a reduced risk of recurrent revascularization. This preventive effect was more pronounced in men compared with other subgroups of patients.
authors.affiliation: Master Program in Long-Term Care and School of Gerontology and Health Management (Dr Hou), School of Nursing (Drs Jeng and Tsai), College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation (Drs Hou and Lai) and Sleep Science Center (Dr Tsai), Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation (Dr Lai), School of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Surgery (Dr Hsu), Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Surgery (Dr Hsu) and Department of Medicine (Dr Shih), School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine (Mr Shih), Department of Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Wen-Hsuan
authors.initials: WH
authors.lastname: Hou
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lai
authors.forename: Chii
authors.initials: C
authors.lastname: Jeng
authors.forename: Chuan-Chih
authors.initials: CC
authors.lastname: Hsu
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Pei-Shan
authors.initials: PS
authors.lastname: Tsai
mesh_terms: D000067575:Administrative Claims, Healthcare; D000328:Adult; D000368:Aged; D000072038:Cardiac Rehabilitation; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D065840:Protective Factors; D012086:Reoperation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013624:Taiwan