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The impact of cardiac rehabilitation program on work ability in patients following percutaneous coronary intervention (PCI): A retrospective cohort study

Document Type : Original Article

Authors

1 Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

2 Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Physical Medicine and Rehabilitation, School of Medicine, Sina (Farshchian) Educational and Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Cardiology, School of Medicine, Farshchian Cardiovascular Subspecialty Medical Center, Hamadan University of Medical Sciences, Hamada, Iran

5 Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

BACKGROUND: Cardiac rehabilitation (CR) is a critical intervention for reducing complications after cardiovascular procedures such as percutaneous coronary intervention (PCI). One of the key outcomes used to evaluate the effectiveness of CR programs is improvement in patients’ work ability. This study aimed to assess the impact of a structured CR program on work ability in patients undergoing PCI.
METHODS: A retrospective study was conducted, comparing 36 patients who participated in a structured CR program following PCI with 36 patients who did not receive rehabilitation. The CR program included educational and exercise components, delivered over four weeks with three sessions per week. Work ability was evaluated three months post-intervention using a standardized questionnaire. Statistical analyses, including independent t-tests and correlation assessments, were performed to examine the relationship between CR participation and work ability.
RESULTS: The two groups were comparable in terms of age, gender, and underlying medical conditions (p > 0.05). Notably, 80% of patients in the CR group demonstrated good to excellent work ability, compared with only 25% in the control group 
(p < 0.001). The mean work ability score was significantly higher in the CR group than in the control group (mean difference = 7.55, p < 0.001).
CONCLUSION: Participation in a cardiac rehabilitation program significantly improves work ability in patients following PCI. These findings highlight the importance of integrating CR into post-PCI care. Future research should focus on randomized clinical trials incorporating diverse rehabilitation protocols and extended follow-up periods to further validate these results.

Keywords

References
1. Safiri S, Karamzad N, Singh K, Carson-Chahhoud K, Adams C, Nejadghaderi SA, et al. Burden of ischemic heart disease and its attributable risk factors in 204 countries and territories, 1990-2019. Eur J Prev Cardiol. 2022 Mar 11;29(2):420-31. https://doi.org/10.1093/eurjpc/zwab213
2. Savira F, Wang BH, Kompa AR, Ademi Z, Owen AJ, Liew D, et al. The impact of coronary heart disease prevention on work productivity: a 10-year analysis. Eur J Prev Cardiol. 2021 May 8;28(4):418-25. https://doi.org/10.1093/eurjpc/zwaa037
3. Nouri F, Feizi A, Taheri M, Mohammadifard N, Khodarahmi S, Sadeghi M, et al. Temporal Trends of the Incidence of Ischemic Heart Disease in Iran Over 15 Years: A Comprehensive Report from a Multi-Centric Hospital-Based Registry. Clin Epidemiol. 2020 Aug 6;12:847-56. https://doi.org/10.2147/clep.s259953
4. Vahed RI. Coping with ischaemic heart disease: views and experiences of key participants, their partners and medical practitioners: Citeseer; 2012.
5. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation. 2021 Feb 23;143(8):e254-43. https://doi.org/10.1161/cir.0000000000000950
6. Cui Q, Naikoo NA. Modifiable and non-modifiable risk factors in ischemic stroke: a meta-analysis. Afr Health Sci. 2019 Jun;19(2):2121-9. https://doi.org/10.4314/ahs.v19i2.36
7. Lippi G, Franchini M, Cervellin G. Diagnosis and management of ischemic heart disease. Semin Thromb Hemost. 2013 Mar;39(2):202-13. https://doi.org/10.1055/s-0032-1333543
8. Byrne RA, Rossello X, Coughlan J, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J Acute Cardiovasc Care. 2024 Jan;13(1):55-161. https://doi.org/10.1093/ehjacc/zuad107
9. Writing Committee Members; Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022 Jan 18;79(2):e21-129. https://doi.org/10.1016/j.jacc.2021.09.006
10. Pogosova N, Saner H, Pedersen SS, Cupples ME, McGee H, Höfer S, et al. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol. 2015 Oct;22(10):1290-306. https://doi.org/10.1177/2047487314543075
11. Laut KG, Hjort J, Engstrøm T, Jensen LO, Hansen H-HT, Jensen JS, et al. Impact of health care system delay in patients with ST-elevation myocardial infarction on return to labor market and work retirement. Am J Cardiol. 2014 Dec 15;114(12):1810-6. https://doi.org/10.1016/j.amjcard.2014.09.018
12. Scafa F, Calsamiglia G, Tonini S, Lumelli D, Lanfranco A, Gentile E, et al. Return to work after coronary angioplasty or heart surgery: a 5-year experience with the “CardioWork” protocol. J Occup Environ Med. 2012 Dec;54(12):1545-9. https://doi.org/10.1097/jom.0b013e3182677d54
13. Pedersen SM, Kruse M, Zwisler ADO, Helmark C, Pedersen SS, Olsen KR. Return to work: does cardiac rehabilitation make a difference? Danish nationwide register-based study. Scand J Public Health. 2023 Mar;51(2):179-87. https://doi.org/10.1177/14034948211062656
14. Biering K, Nielsen TT, Rasmussen K, Niemann T, Hjollund NH. Return to work after percutaneous coronary intervention: the predictive value of self-reported health compared to clinical measures. PLoS One. 2012;7(11):e49268. https://doi.org/10.1371/journal.pone.0049268
15. Sadeghi M, Shabib G, Masoumi G, Amerizadeh A, Shahabi J, Heidari R, et al. A Systematic Review and Meta-analysis on the Prevalence of Smoking Cessation in Cardiovascular Patients After Participating in Cardiac Rehabilitation. Curr Probl Cardiol. 2021 Mar;46(3):100719. https://doi.org/10.1016/j.cpcardiol.2020.100719
16. Beauchamp A, Worcester M, Ng A, Murphy B, Tatoulis J, Grigg L, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart. 2013 May;99(9):620-5. https://doi.org/10.1136/heartjnl-2012-303022
17. Yuval R, Halon DA, Lewis BS. Perceived disability and lifestyle modification following hospitalization for non-ST elevation versus ST elevation acute coronary syndromes: the patients’ point of view. Eur J Cardiovasc Nurs. 2007 Dec;6(4):287-92. https://doi.org/10.1016/j.ejcnurse.2007.02.002
18. Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler A-D, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021 Nov 6;11(11):CD001800. https://doi.org/10.1002/14651858.cd001800.pub4
19. Hansen D, Niebauer J, Cornelissen V, Barna O, Neunhäuserer D, Stettler C, et al. Exercise Prescription in Patients with Different Combinations of Cardiovascular Disease Risk Factors: A Consensus Statement from the EXPERT Working Group. Sports Med. 2018 Aug;48(8):1781-97. https://doi.org/10.1007/s40279-018-0930-4
20. Adel M, Akbar R, Ehsan G. Validity and reliability of work ability index (WAI) questionnaire among Iranian workers; a study in petrochemical and car manufacturing industries. J Occup Health. 2019 Mar;61(2):165-74. https://doi.org/10.1002/1348-9585.12028
21. Adam CA, Erskine J, Akinci B, Kambic T, Conte E, Manno G, et al. Exercise Training and Cardiac Rehabilitation in Patients After Percutaneous Coronary Intervention: Comprehensive Assessment and Prescription. J Clin Med. 2025 Feb 27;14(5):1607. https://doi.org/10.3390/jcm14051607
22. Pourafkari L, Ghaffari S, Shahamfar J, Tokhmechian L, Nader ND. The psychological effects of cardiac rehabilitation after coronary revascularization. Turk Kardiyol Dern Ars. 2016 Apr;44(3):228-36. https://doi.org/10.5543/tkda.2015.56846
23. Prabhu NV, Maiya AG, Prabhu NS. Impact of Cardiac Rehabilitation on Functional Capacity and Physical Activity after Coronary Revascularization: A Scientific Review. Cardiol Res Pract. 2020 Mar 21;2020:1236968. https://doi.org/10.1155/2020/1236968
24. Tjahjono CT, Arthamin MZ. The role of cardiac rehabilitation in facilitating return to work after cardiovascular events. Med Res Arch. 2024 Dec;12(12):1-13. https://doi.org/10.18103/mra.v12i12.6016
25. Sadeghi M, Rahiminam H, Amerizadeh A, Masoumi G, Heidari R, Shahabi J, et al. Prevalence of Return to Work in Cardiovascular Patients After Cardiac Rehabilitation: A Systematic Review and Meta-analysis. Curr Probl Cardiol. 2022 Jul;47(7):100876. https://doi.org/10.1016/j.cpcardiol.2021.100876
26. Hegewald J, Wegewitz UE, Euler U, van Dijk JL, Adams J, Fishta A, et al. Interventions to support return to work for people with coronary heart disease. Cochrane Database Syst Rev. 2019 Mar 14;3(3):CD010748. https://doi.org/10.1002/14651858.cd010748.pub2
27. Sun W, Gholizadeh L, Perry L, Kang K. Predicting Return to Work Following Myocardial Infarction: A Prospective Longitudinal Cohort Study. Int J Environ Res Public Health. 2022 Jun 30;19(13):8032. https://doi.org/10.3390/ijerph19138032
28. Hu Y, Zhou T, Li X, Chen X, Wang X, Xu J, et al. Factors influencing return to work 3 months after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease: A single-center, cross-sectional study. PLoS One. 2023 Apr 19;18(4):e0284100. https://doi.org/10.1371/journal.pone.0284100
29. Sugiharto F, Nuraeni A, Trisyani Y, Melati Putri A, Aghnia Armansyah N. Barriers to Participation in Cardiac Rehabilitation Among Patients with Coronary Heart Disease After Reperfusion Therapy: A Scoping Review. Vasc Health Risk Manag. 2023 Aug 31;19:557-70. https://doi.org/10.2147/vhrm.s425505
30. Quattrone F, Lesaine E, Domecq S, Legrand J-P, Miganeh Hadi S, Coste P, et al. Socio-geographical factors associated with cardiac rehabilitation participation after percutaneous coronary intervention: A registry-based cohort study from France. Eur J Prev Cardiol. 2025 Feb 20:zwaf087. https://doi.org/10.1093/eurjpc/zwaf087
31. Varnfield M, Karunanithi M, Lee C-K, Honeyman E, Arnold D, Ding H, et al. Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial. Heart. 2014 Nov;100(22):1770-9. https://doi.org/10.1136/heartjnl-2014-305783
32. Sukul D, Seth M, Barnes GD, Dupree JM, Syrjamaki JD, Dixon SR, et al. Cardiac Rehabilitation Use After Percutaneous Coronary Intervention. J Am Coll Cardiol. 2019 Jun 25;73(24):3148-52. https://doi.org/10.1016/j.jacc.2019.03.515
33. Reibis R, Salzwedel A, Abreu A, Corra U, Davos C, Doehner W, et al. The importance of return to work: How to achieve optimal reintegration in ACS patients. Eur J Prev Cardiol. 2019 Sep;26(13):1358-69. https://doi.org/10.1177/2047487319839263
ARYA Atherosclerosis Journal
Volume 21, Issue 6
November and December 2025
Pages 69-79
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