Five-year follow-up findings from a randomized controlled trial of cardiac rehabilitation for heart failure

Abstract

Background: A follow-up study was carried out on the 5-year status of the surviving patients (n=179 at 6 months) of a 24-week randomized controlled trial comparing cardiac rehabilitation (CR) with heart failure outpatient clinic care (standard care).

Methods: In the original randomized controlled trial, 200 patients (60-89 years, 132 men) with New York Heart Association II/III heart failure confirmed by echocardiography had been randomized (2000-2001). At the 5-year follow-up, the initial trial measures (6-min walk test, Minnesota living with heart failure, EuroQol health-related quality of life, and routine biochemistry) were repeated if the patient was in a satisfactory condition. Data on deaths and admissions were obtained from the medical records department.

Results: Over half of the original participants (n=119, 59.5%) were alive at 5 years (mean age 75.2 years), and most (94%) attended the clinic for assessment. A sustained improvement from baseline for both groups in Minnesota living with heart failure, but not in EuroQol was observed, and the majority of the other measures had deteriorated. In contrast to the CR group, the standard care group showed a significant deterioration in walking distance (5 versus 11%; P<0.05). More patients in the CR group were taking regular exercise (71 versus 51%; P<0.05). No significant differences between the groups in health care utilization or survival were observed.

Conclusion: A 24-week CR programme for patients with stable heart failure showed some long-term benefit at 5 years. Differences in the mean values of most of the functional and quality of life measures were evidently to the advantage of the CR group, which also showed a better exercise profile.