Rationale:

Depression increases following cardiac events. Most current literature focuses on the benefits of antidepressant treatment with little to no mention of the benefits of cardiac rehabilitation (CR). Since CR improves quality of life, we hypothesized that CR would positively impact patients with depression without pharmaceutical intervention with a shorter CR than reported previously.

Objective:

To assess the impact of CR on patients exhibiting depression following a cardiac event.

Methods:

Since August 2000, all (n = 324) patients (74% men) were administered The Nine-Symptom Checklist (9Sx) (brief form of PRIME-MD Patient Health Questionnaire) and SF-36 at commencement (T1) and completion of CR (T2). Scores >=12 on the 9Sx correlated with possible major depressive syndrome/disorder; scores >=6 suggested other depressive syndrome. Lower 9Sx scores indicated improvement. The SF-36 measured nine domains of quality of life; higher scores indicated improvement.

Results:

For the total population, completion of CR resulted in a statistically significant lowering of mean 9Sx scores (T1 5.93->T2 3.52; P <.0001). In the subset of patients scoring >=6 on the 9Sx, CR also resulted in improved scores in both men and women (Men: T1 10.89->T2 5.93; Women: T1 11.23->T2 5.65). Mean scores in the patients scoring >=6 decreased from T1 39% to T2 14% in patients scoring >12 values decreased from T1 41% to T2 14%.

In patients undergoing coronary artery bypass grafting (CABG), initial T1 scores were significantly higher compared with the non-CABG population (7.79 vs 6.10, P <.0014). CR resulted in similar improvements in T2 scores that did not differ from the non-CABG population (2.98 vs 3.55, NS)

For the SF-36, matched paired t-tests indicated all domains of the SF-36 improved significantly (P <.0001 for all).

Conclusions:

Depressive symptoms decrease and quality of life increases in patients undergoing 4-6 weeks of CR without pharmaceutical intervention.