Two-year results of a controlled study of residential rehabilitation for patients treated with percutaneous transluminal coronary angioplasty - A randomized study of a multifactorial programme

Aims In a multifactorial lifestyle behaviour programme, of 2 years duration , to study the maintenance of achieved behaviour and risk factor-related ch anges. Methods and Results Out of a consecutive population of 151 patients treated with percutaneous transluminal angioplasty under 65 years of age, 87 were randomly allocated to an intervention group (n = 46) or to a control group (n = 41). The programme started with a 4 week residential stay, which was f ocused on health education and the achievement of behaviour change. During the first year of follow-up, a maintenance programme included regular conta cts with a nurse. while no further rehabilitative efforts were offered duri ng the second pear. One patient died (control). During the second year the proportion of hospitalized patients was lower in the intervention group (4% vs 20%; P < 0.05). Patients in the intervention group improved several lif estyle dependent behaviours: diet (index at 0, 12 and 24 months): 10.5 +/- 3.4, 12.9 +/- 2.5 and 12.4 +/- 2.6 in the intervention group (I) vs 10.1 +/ - 3.2, 10.7 +/- 3.0 and 11.8 +/- 3.2 in the control group (C); P < 0.05, ex ercise sessions per week: 2.5 +/- 2.3, 4.5 +/- 1.9 and 4.4 +/- 2.1 (I) vs 3 .1 +/- 2.2, 3.5 +/- 2.3 and 3.7 +/- 2.7(C); P < 0.05, and smoking; 18%, 6% and 9% (I) vs 12%, 21% and 18% (C); P < 0.05. This corresponded to improvem ent in exercise capacity (O, 12 and 24 months): 156 +/- 42. 174 +/- 49 and 165 +/- 47 W (I) vs 164 +/- 40, 163 +/- 49 and 156 +/- 48 watts (C); P < 0. 05. There were no significant differences between the two groups with regar d to serum cholesterol levels at 0 and 24 months: 5.4 +/- 0.8 and 5.2 +/- 0 .9 mmol.1(-1) (I) vs 5.4 +/- 1.0 and 4.9 +/- 0.9 mmol. 1(-1) (C); ns: low d ensity lipoprotein cholesterol level: 3.6 +/- 0.8 and 3.4 +/- 0.8 mmol.1(-1 ) (I) vs 3.7 +/- 0.9 and 3.3 +/- 0.7 mmol. 1(-1) (C); ns, triglyceride leve l: 2.2 +/- 1.6 and 1.8 +/- 1.3 mmol. 1(-1) (I) vs 2.2 +/- 1.4 and 1.6 +/- 0 .6 mmol.1(-1) (C); ns, body mass index (0, 12 and 24 months): 27.5 +/- 4.5, 27.0 +/- 4.3 and 27.4 +/- 4.5 kg.m(-2) (I) vs 26.8 +/- 2.8, 26.9 +/- 2.7 a nd 26.9 +/- 3.2 kg.m(-2) (C); ns, waist/hip ratio or blood pressure. The tw o groups did not differ in quality of life, or psychological factors. Retur n to work after 12 and 24 months was 74% and 78% (I) vs 68% and 61% (C); ns . Conclusion This rehabilitation programme influenced important lifestyle beh aviour and reduced some, but not all, important risk factors (C) 1999 The E uropean Society of Cardiology.