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Abstract

Objective: Cardiac rehabilitation (CR) is recognized as an essential intervention to improve survival in patients with chronic heart conditions, including those undergoing coronary artery bypass graft (CABG) surgery.
Methodology: This single-center observational study analyzed all CABG procedures performed between 2013 and 2015. Patients were divided into two groups after CABG: participated in CR (CR arm) and those who refused or were unable to participate in CR (non-CR arm). The primary outcomes included all-cause mortality, CV mortality, sudden cardiac death (SCD), post-CABG acute coronary syndrome (ACS), cerebrovascular accident (CVA) and major adverse cardiovascular events (MACE =composite of ACS, CVA and CV death).
Results: A total of 1,890 patients were included (CR= 1,641; non-CR= 129) in the study. The non-CR group had a higher prevalence of chronic obstructive pulmonary disease, hyperlipidemia, chronic kidney disease (CKD), prior ACS, congestive heart failure, and were more frequently prescribed antiarrhythmic drugs post-CABG as compared with the CR group. The adjusted multivariate analysis showed that the non-CR vs CR had significantly higher all-cause mortality (12.9% vs 2.6%) (Odds Ratio [OR] = 5.49, 95% CI: 3.046-9.894, p< 0.001), CV mortality (3.1% vs 1.1%) (OR = 2.87, 95% CI: 0.963-8.621, p = 0.048). The incidence of SCD was significantly higher in the non-CR group (4.7%) compared to the CR group (1.7%) (OR = 6.76, 95% CI: 2.494-18.182, p < 0.001). No significant differences were observed between the groups in terms of post-CABG ACS (OR = 0.59, 95% CI: 0.211-1.621, p = 0.297), CVA (OR = 1.11, 95% CI: 0.394-3.125, p = 0.844), or MACE (OR =1.13, 95% CI: 0.608-2.096, p = 0.701).
Conclusion: Participation in cardiac rehabilitation following CABG surgery is associated with significantly improved survival, reduced all-cause and CV mortality, and lower rates of sudden cardiac death.