A controlled trial of a behavioral and educational intervention following coronary artery bypass surgery

Patients who have undergone coronary artery bypass graft surgery (CABG) are obvious candidates for rehabilitation programs because of the potential for progression of disease. Such programs have been shown to foster risk-factor modification, improve quality of life, and prolong survival among post-myocardial infarction (MI) patients. However, the efficacy of these programs has not been established among patients who have undergone CABG.

A randomized controlled trial was employed to evaluate whether a behavioral and educational cardiac rehabilitation program was effective in modifying cardiovascular disease risk factors and improving quality of life in a cohort of 86 patients after CABG. Patients were recruited from the cardiac ward of a large teaching hospital and were block-randomized to either an intervention group or routine care. Subjects in the intervention group attended 6 weekly group sessions following hospital discharge, and booster sessions at 8 months and 1 year. They also received a personalized behavior modification program based on their baseline risk factors. Risk factor and quality of life measures were recorded at baseline (6 weeks after surgery), 4 months, 8 months, and 1 year.

The results indicated few differences between the study groups. However, the intervention group's aerobic capacity (VO2max) improved over that of the routine care group. With regard to the quality of life variables, all patients tended to improve steadily over time.

The relatively moderate success of this intervention program compared with various post-MI studies may be indicative of differences between the treatment needs of patients after acute myocardial infarction or CABG. Future post-CABG rehabilitation research should explore these patients' unique treatment needs, and investigate a variety of program strategies.