Impact of functional recovery on patients having heart surgery.

Objective: To describe the results of a program developed to manage institutional postacute care (IPAC) (postacute skilled nursing, inpatient rehabilitation facility, and long-term acute care) in a CMS Bundled Payments for Care Improvement (BPCI) project for coronary artery bypass graft (CABG) surgery.

Study Design: We compared pre- and postutilization patterns during a 3-year period by evaluating risk-adjusted national, state, and other BPCI participant comparisons using a difference-in-differences (DID) analysis in a large urban community tertiary center with a CABG surgery program. Included in the analysis were all Medicare patients receiving CABG surgery at the institution (n = 504), across the nation (n = 213,423), and at other BPCI institutions (n = 4939).

The Association of Tobacco Use and Gender to Cardiac Rehabilitation Outcomes: A Preliminary Investigation.

Introduction: Cardiac rehabilitation (CR) outcomes are measured in terms of cardiovascular disease (CVD) risk factor reductions, and these predict long-term cardiac status. This report examines whether reported tobacco use has differential effects on successful cardiovascular risk factor modification, especially for women who have greater smoking-related CVD consequences than men.

Methods: A retrospective cohort analysis was conducted on 1138 adults (74% male) with diagnosed CVD who participated in ≥7 weeks of a comprehensive CR program.

Randomized trial assessing the impact of a musculoskeletal intervention for pain before participating in a weight management program.

Purpose: Obesity increases the risk of developing physical disability and pain. Persons with a body mass index (BMI) of 30 kg/m or more have an increased risk for osteoarthritis compared with those with a BMI between 25 and 29 kg/m. The purpose of this study was to examine the effect of treatment directed at reducing musculoskeletal pain on weight loss in obese subjects prior to participation in a 6-month weight management (WM) program.

The effect of a women- and healthcare-provider-focused heart health awareness initiative on diagnostic catheterization rates in women at community hospitals.

The American College of Cardiology-National Cardiovascular Data Registry was used to assess the impact of a community education campaign related to heart disease in women on the number of women, relative to men, receiving diagnostic catheterization prior to initiation of the campaign and at 2-year follow-up. Catheterizations fell 7.03% in men and 0.

Effect of a weight management program on the determinants and prevalence of metabolic syndrome.

Objective: As prevalence of obesity and metabolic syndrome (met synd) rises, establishing effective, community-based treatments is imperative. Our investigation sought to evaluate and report the effect of a weight management program on the prevalence and determinants of met synd, and the effect of participation level.

Methods And Procedures: Between 10 July 2001 and 17 November 2005, 339 of 574 individuals enrolled in and completed our 6-month weight management program at the McConnell Heart Health Center in Columbus, Ohio.

Cardiovascular disease risk of type 2 diabetes mellitus and metabolic syndrome: focus on aggressive management of dyslipidemia.

Type 2 diabetes mellitus and the closely related metabolic syndrome markedly increase the risk of cardiovascular disease a major contributor is the dyslipidemia. Recent studies and new national guidelines suggest these very high risk patients with cardiovascular disease achieve optional low density lipoprotein cholesterol (LDL-C) level of less than 70 mg/dl. In addition there may be no threshold to begin therapeutic lifestyle change and pharmacologic therapy to reduce LDL-C by 30-40%.

Depressive symptoms and sex affect completion rates and clinical outcomes in cardiac rehabilitation.

Symptoms of depression are often seen in patients with coronary heart disease. Symptoms appear more commonly in women and are negatively associated with measures of cardiovascular health. Using multiple logistic regression analyses, the authors evaluated the independent effects of depression (as measured by the Beck Depression Inventory [BDI-II]) and sex on cardiac rehabilitation (CR) completion.

A systematic approach to improve lipids in coronary artery disease patients participating in a cardiac rehabilitation program.

Purpose: To determine the effectiveness of an intervention, directed toward the primary care physician (PCP), to improve the number of patients treated to low-density lipoprotein cholesterol (LDL-C) goal in a cardiac rehabilitation (CR) population.

Methods: A pre-post intervention cohort comparison using data collected from participants in a CR program with LDL-C > or =100 mg/dL at entry. The control cohort participated in CR between 1/00 and 10/02, 41.

Effect of a community-based weight management program on weight loss and cardiovascular disease risk factors.

Objective: The purpose of our retrospective database analysis was to describe and evaluate the outcomes of a weight loss intervention in a community medical wellness center.

Research Methods And Procedures: Four hundred eighteen overweight and obese adults entered the program between 2001 and 2004. Forty-seven percent completed the 6-month program designed using standards and recommendations established by the NIH, the American Dietetic Association, and the American Academy of Sports Medicine.

Cardiac rehabilitation is associated with an improvement in C-reactive protein levels in both men and women with cardiovascular disease.

Purpose: Inflammation is involved in the development of atherosclerotic plaque. The most studied indicator of inflammation in coronary heart diseases (CHD) is C-reactive protein (CRP) which has prognostic significance in those with CHD. The purpose of this study is to evaluate the effect of participation in cardiac rehabilitation (CR) on this marker of vascular inflammation, CRP.

Clinical profile and outcomes of diabetic and nondiabetic patients in cardiac rehabilitation.

Background: Patients with diabetes mellitus have increased risk of cardiovascular disease; however, there are limited data addressing cardiac rehabilitation in these patients. This study assessed the effectiveness of participation in cardiac rehabilitation on clinical outcomes after myocardial infarction and/or revascularization procedures in diabetic and nondiabetic patients.

Methods: Analysis on 1505 patients completing a minimum of 7 weeks of a 12-week cardiac rehabilitation program included fasting lipid profile and glucose, body mass index, and metabolic equivalent time in patients with diabetes (n = 292) and without diabetes (n = 1213).

Independent effect of cardiac rehabilitation on lipids in coronary artery disease.

Purpose: We evaluate the effects cardiac rehabilitation (CR) participation independent of using lipid-altering agents (LAAs) on low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol, and triglyceride. Measurements included absolute and relative change in lipids and increases in percent of patients achieving goals.

Methods: Analysis of 766 patients who participated in CR between 2000 and 2003 was performed.

Gender differences in ventricular arrhythmia recurrence in patients with coronary artery disease and implantable cardioverter-defibrillators.

Objectives: We sought to determine whether men and women with coronary artery disease (CAD) and implantable cardioverter-defibrillators (ICDs) differ in frequency of arrhythmia recurrence and whether gender differences are independent of clinical, electrocardiographic, and electrophysiologic characteristics.

Background: Epidemiologic studies show that women have a lower rate of sudden cardiac death (SCD) than men, even among patients with CAD. Whether this is due to differing susceptibilities to ischemia or to arrhythmia is unknown.

Examination of gender bias in the evaluation and treatment of angina pectoris by cardiologists.

One hundred fifty-eight patients (76 men and 82 women) presenting to an outpatient cardiology clinic with a new complaint of angina were prospectively followed to determine if there was a gender bias in the management of suspected coronary artery disease when physicians trained in cardiology managed their care. Overall, there were no differences in the percentage of women who underwent noninvasive evaluation, invasive evaluation, and treatment of suspected coronary artery disease compared with men.

Primary Prevention of Hypertension in Women.

Cardiovascular disease remains the leading cause of death in women in the U.S. In women greater than 45 years of age, 60% of Caucasian women and 79% of African-American women have hypertension.