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Usefulness of Cardiac Rehabilitation After Spontaneous Coronary Artery Dissection
Chayakrit Krittanawong1, Marysia S Tweet1, Sarah E Hayes2
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Insights
Most patients with spontaneous coronary artery dissection (SCAD) attend cardiac rehabilitation (CR) and report benefits. However, many do not participate because their healthcare provider did not recommend CR.
Area of Science:
- Cardiology
- Preventive Cardiology
- Rehabilitation Medicine
Background:
- Spontaneous coronary artery dissection (SCAD) is an emerging cause of myocardial infarction (MI).
- The role and effectiveness of cardiac rehabilitation (CR) for SCAD patients remain underexplored.
- SCAD predominantly affects young women, highlighting the need for tailored post-MI care.
Purpose of the Study:
- To investigate the participation rates and perceived benefits of cardiac rehabilitation (CR) among patients diagnosed with SCAD.
- To identify barriers to CR participation in the SCAD population.
- To inform clinical practice regarding CR referral for SCAD survivors.
Main Methods:
- A retrospective analysis of a large cohort (n=354) of SCAD patients from the Mayo Clinic SCAD Registry (2010-2014).
- Data collection included demographics, clinical data, mental health status, and CR participation details via medical records and questionnaires.
- Analysis focused on CR attendance, reported benefits, and reasons for non-participation.
Main Results:
- The majority of SCAD patients (76%) attended at least one CR session, averaging 18 sessions.
- Most participants reported significant physical (82%) and emotional (75%) benefits from CR.
- The primary barrier to CR non-participation was the lack of a healthcare provider recommendation (57% of non-participants).
Conclusions:
- Cardiac rehabilitation is frequently utilized by SCAD patients and is associated with reported benefits.
- Healthcare provider recommendation is a critical factor influencing CR participation in SCAD survivors.
- Strategies to improve CR referral rates are needed to ensure optimal recovery for SCAD patients.
Abstract:
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction; however, the role of cardiac rehabilitation (CR) for patients with SCAD has not been well defined. To further understand CR in patients with SCAD, we studied a large cohort of patients with confirmed SCAD enrolled in the Mayo Clinic SCAD Registry from January 2010 to December 2014 (n = 354). Demographics, clinical characteristics, mental health status, and details about CR participation and experience were collected through medical record review and questionnaires. Participants at time of SCAD were 46 ± 10 years old; 96% were women. Most (76%) attended ≥1 CR sessions, averaging 18 ± 12 sessions. Most reported CR-related physical and emotional benefits (82% and 75%, respectively). Of the CR nonparticipants, 57 of 85 reported not participating because CR was not recommended by their health care provider. Other reasons included inadequate transportation (10 of 85), no insurance coverage (7 of 85), cost (2 of 85), no energy (2 of 85), being too ill (2 of 85), and miscellaneous comments (5 of 85). In conclusion, 3 of 4 of patients with SCAD participated in CR, most of whom reported benefit. Lack of recommendation for CR by a health care provider was the primary reason patients did not participate.
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