From the Guidelines
Yes, a patient status post cardiac catheterization (cardiac cath) and stent placement requires cardiac rehabilitation.
Key Points
- Cardiac rehabilitation is a complex, multicomponent intervention that includes exercise training, health education, cardiovascular risk management, and psychological support, which has been shown to improve cardiovascular outcomes in patients with heart disease 1.
- Data from randomized, controlled trials support cardiac rehabilitation as a clinically effective and cost-effective intervention for patients after coronary revascularization, including those who have undergone cardiac catheterization and stent placement 2.
- Medically supervised exercise programs, such as cardiac rehabilitation, should be recommended to patients after percutaneous coronary intervention (PCI), including cardiac catheterization and stent placement, particularly for moderate- to high-risk patients 2.
- Cardiac rehabilitation programs can be delivered in a traditional center-based setting or through home-based models, which have been shown to be effective in improving clinical outcomes in selected patients 3.
- Key components of cardiac rehabilitation include: + Exercise training + Health education + Cardiovascular risk management + Psychological support
- Benefits of cardiac rehabilitation include: + Reduced all-cause mortality and cardiac mortality + Improved exercise tolerance + Improved cardiac symptoms + Improved lipid levels + Improved cigarette smoking cessation rates + Improved medical regimen compliance + Improved psychosocial well-being ### Recommendations
- Patients who have undergone cardiac catheterization and stent placement should be referred to a cardiac rehabilitation program to improve their cardiovascular outcomes and reduce their risk of future cardiac events.
- The choice of cardiac rehabilitation delivery model, whether traditional center-based or home-based, should be individualized based on the patient's needs and preferences.
- Cardiac rehabilitation programs should be tailored to address the patient's specific needs, including exercise training, health education, and psychological support.
From the Research
Cardiac Rehabilitation after Cardiac Catheterization and Stent Placement
- Cardiac rehabilitation is a comprehensive multidisciplinary program that aims to improve daily function and reduce cardiovascular risk factors in patients with cardiovascular disease 4.
- The program includes interventions such as supervised exercise, counseling on nutrition, screening for and managing depression, and assuring up-to-date immunizations 4.
- Cardiac rehabilitation is recommended for patients following myocardial infarction, bypass surgery, and stent placement, and for patients with heart failure, stable angina, and several other conditions 4, 5.
Benefits of Cardiac Rehabilitation
- Cardiac rehabilitation has been shown to improve clinical outcomes, including mortality rates, depression, functional capacity, and medication adherence 4, 5.
- A study found that systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation can enhance cardiac function recovery, quality of life, and cardiopulmonary exercise tolerance 6.
- Another study found that exercise training is safe after coronary stenting, with a low rate of acute coronary syndrome (ACS) related to exercise 7.
Timing of Cardiac Rehabilitation
- The current literature suggests that arterial dysfunction induced by catheterization recovers 4-12 weeks following catheterization, and it is proposed that CAD patients start an exercise training programme between 2 and 4 weeks post-PCI 8.
- A study found that there is no justification to delay cardiac rehabilitation after coronary stenting, and exercise training seems safe even in the early rehabilitation group 7.