Background:

Depression has been identified as a risk factor for increased cardiovascular morbidity and mortality. Therefore, St. Peter's Cardiac Rehabilitation Center has implemented a depression screening program that follows patients for up to one year.

Objective:

To assess the effect of participation in cardiac rehabilitation (CR) on depression in patients following cardiac events.

Methods:

Patients who presented for CR in 2003 and 2004 completed the Beck Depression Inventory - Primary Care (BDI-PC) upon enrollment, upon completing the 12-week program, and one year subsequent to program completion.

Results:

A total of 188 patients completed the program during the study interval. On enrollment, the average BDI-PC score was 1.26 (95%CI 1.02 to 1.50). At the completion of CR (12-weeks later) it was 1.01 (95% CI 0.77 to 1.24). This represents a statistically significant (P < 0.03) reduction in the BDI-PC scores from baseline. Further, the number of patients with a total BDI-PC score >=3 declined from 38 (20.12%) to 11 (5.85%).

Of the 94 patients who responded to the 1-year follow-up survey, average BDI-PC score at baseline was 1.23 (95% CI 0.93 to 1.53), at 12 weeks it was 0.92 (95% CI 0.61 to 1.24) and at 1-year it was 1.22 (95% CI 0.81 to 1.63). Although not statistically significant this represents a similar downward trend during the CR program The number of patients with an average BDI-PC score of >=3 was 21 (22.3%) at the start, 8 (8.5%)% at 12 weeks, and 18 (19.14%) at the 1-year follow-up

Conclusions:

Patients participating in CR exhibit decreasing levels of depression until completion of CR. After 1-year the number of patients with depressive symptoms returned close to baseline. This suggests the need for long-term follow-up of these patients.