Depressive symptom improvements linked to functional gains during cardiac rehab

In acute coronary syndrome (ACS) patients with depression who are undergoing cardiac rehabilitation, an improvement in depressive symptoms appear to be followed by an increase in walking fitness, as shown in a retrospective study.

Researchers used data from the UK National Audit of Cardiac Rehabilitation and looked at 4,585 ACS patients (mean age 63.53 years, 78.1 percent male) who underwent valid incremental shuttle walk test (ISWT) and the Hospital Anxiety and Depression Scale (HADS) assessments before and after cardiac rehabilitation.

The minimum clinically important difference (MCID) in anxiety and depression was defined as >1.7-score improvement in the HADS score, while the MCID in walking fitness was defined as >70-m improvement in ISWT.

In multivariable logistic regression models, patients who achieved the MCID for depression had 23-percent greater odds of meeting the MCID for walking fitness (odds ratio, 1.23, 95 percent confidence interval, 1.01–1.49).

With regard to cardiac rehabilitation delivery, centre-based group programmes and hybrid programmes (combining centre-based and home-based components) were associated with increased odds of achieving the MCID for walking fitness compared with home-based programmes.

Conversely, older age, female sex, physical inactivity, obesity, and longer waiting times to commence cardiac rehabilitation were associated with reduced odds of achieving the MCID for walking fitness.

These findings underscore the importance of addressing depression within cardiac rehabilitation, according to the researchers.