A new study by Michigan Medicine has found that patients who participate in cardiac rehabilitation following heart surgery have a decreased risk of death years after their operation.
This correlation becomes more pronounced the more sessions patients attend.
Cardiac rehabilitation is a medically supervised program that combines lifestyle modifications, education, and physical activity to assist patients in their recovery and lower the risk of future complications.
Despite its proven benefits, patient participation remains subpar, notes the study’s senior author Michael P. Thompson, Ph.D., an assistant professor of cardiac surgery at the University of Michigan Medical School.
The study involved the analysis of over 6,400 Medicare fee-for-service claims linked to clinical registry data.
The data pertained to Michigan residents who underwent coronary artery bypass grafting (heart bypass surgery) from 2015 to late 2019.
This surgical procedure improves blood flow to the heart by connecting a healthy artery or vein from another part of the body to a part of the coronary artery that is blocked.
The research found that patients who underwent cardiac rehabilitation after heart bypass surgery had a 3-5% absolute reduction in mortality rates in the two years following the procedure.
This benefit was most pronounced in patients who completed 36 or more sessions, the recommended number for heart bypass patients.
Thompson emphasized that while any attendance at rehabilitation sessions was better than none, patients benefitted more from attending a higher number of sessions.
Over half of the patients attended a single session of cardiac rehabilitation, but only 12% completed all 36 sessions, despite being referred to the program 94% of the time.
This indicates that referral alone is insufficient to ensure participation, says the study’s first author Tyler M. Bauer, M.D., a general surgery resident at U-M Health.
The study also found a notable gap between cardiac rehabilitation referral and actual use, with only 5% of the variation in cardiac rehab use being attributable to the hospital where a patient had their procedure.
Notably, a previous 2022 Michigan Medicine study found that Black patients, women, older adults, and those with additional medical conditions were significantly under-referred to cardiac rehab.
“Minority and underserved populations face many barriers to cardiac rehab, but improving referral, attendance, and adherence in these populations may be an effective strategy to mitigating longstanding disparities in cardiovascular outcomes,” Thompson suggested.
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The study was published in The Annals of Thoracic Surgery.
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