Cardiac Rehab is Very Important – Don’t Be a Drop-Out!

After a heart attack, Medicare will pay for at least 36 cardiac rehabilitation sessions.  But those who get a prescription tend to drop out after a time; it’s been shown that only 18% of the patients who attend at least one rehab session actually complete the entire series of 36.  Scientists at Duke Clinical Research Institute have analyzed the costs of dropping out prematurely, and published their findings in the journal Circulation.   

The data came from medical records of more than 30,000 Medicare patients over 65 who attended at least one cardiac rehab session between 2000 and 2005.  This represented a nationwide 5% sampling. 

The average number of sessions attended was 25; about 60% attendees had had a coronary artery bypass surgery, and 20% were post-heart attack.  They were overwhelmingly white and mostly male.  

Patients who attended 36 sessions had a 14% lower risk of death and a 12% lower risk of heart attack than those who attended 24 sessions; a 22% lower risk of death and a 23% lower risk of heart attack than those who attended 12 sessions; and a 47% lower risk of death and a 31% lower risk of heart attack than those who attended 1 session.  The gains regarding lower mortality were concentrated in the first 18 sessions of rehab.  On the other hand, reduction in heart attack risk was spread more evenly over the total number of sessions attended.

The benefits of cardiac rehab on mortality and event-free survival are obvious.  The chief author of the study concludes that the preponderance of white males means that there’s need for an effort to persuade women and non-whites to attend initially.  And then it’s important to ensure everyone in the program becomes a regular attendee for as long as possible.