The Impact of Cardiac Rehabilitation on the Level of Anxiety and Symptoms of Depression in Patients after Coronary Revascularization

Abstract

Introduction. The coexistence of depression and anxiety disorder significantly worsens the results of treatment and increases the risk of recurrent cardiovascular incidents. The aim of the study was to assess the impact of cardiac rehabilitation on anxiety and depression symptoms in patients after interventional cardiology or coronary artery bypass graft (CABG). Material and Methods. The study enrolled 40 participants aged 70.75±7.38 years, treated interventionally for ACS or undergoing urgent coronary artery bypass graft (CABG). Patients participated in 3-week stationary early cardiac rehabilitation. At the beginning and end of the study, the Beck Depression Inventory (BDI) and Spielberger's State-Trait Anxiety Inventory (STAI) were performed. Results. 92.5% of subjects had at least one comorbidity, mostly hypertension (67.5%) and heart failure (60.0%). At the beginning the BDI level was 14.55±6.47; depression symptoms were present in 65% of subjects. At the end, BDI decreased significantly to 8.28±5.26; p<0.001. BDI was statistically significantly higher at the beginning and end in women than in men (17.94±7.07 vs. 11.78±4.40; p<0.05 and 10.56±5.90 vs. 6.41±3.88; p<0.01). Persons before rehabilitation were characterized by medium and low levels of STAI-X1 anxiety (31.80±7.24 and STAI-X2: 35.98±8.29). Finally, anxiety decreased statistically significantly to 26.40±6.30 and 29.80±6.57; p<0.001. At the beginning and end, it strongly correlated positively with the severity of depressive symptoms (STAI-X1 R=0.76; p<0.001, STAI-X2 R=0.70; p<0.001 and R=0.76; p<0.001, R=0.70; p<0.001). Conclusions. Cardiac rehabilitation contributes significantly to reducing anxiety levels and reducing symptoms of depression. Implementation of these interventions as soon as possible brings the best results, contributing to reducing the risk of coronary events.