Cardiac Rehabilitation, Quality Of Life, And Depression In Patients With Cardiovascular Disease: A Meta-analysis

Various factors, including a diminished perception of quality of life (QoL), depression (Depre), adverse psychological impacts, lack of physical activity, sedentary habits, and an unsuitable lifestyle, constitute different variables that contribute to the onset of a cardiac event and elevate the risk of encountering a second cardiovascular episode. Cardiac Rehabilitation Programs (CRP) are Class 1A recommendations in professional guidelines for treating patients with cardiovascular disease. Purpose: This meta-analysis aims to determine whether, in addition to the already documented benefits in functional capacity, there are also improvements in psychosocial aspects, QoL, and Depre following a CRP. Methods: The meta-analysis was conducted following the PRISMA guidelines. Six electronic databases were used to identify potentially eligible articles. The search was focused on articles that used instruments to assess both QoL and Depre before and after participation in a CRP. Articles employing an intragroup design (pre and post-test) and published in English or Spanish were sought. Effect sizes (ES) were analyzed using OpenMEE software with the random effects model (REML) and Jamovi version 2.0.0.0. Heterogeneity and inconsistency were calculated using Cochran's Q and tests in the OpenMee software. A funnel plot and Egger's test were also performed using Jamovi version 2.0.0.0.Results: 43 articles were assessed in full text, and 15 articles were included, comprising 14 ES for QoL and 14 ES for the Depre, with a sample size of 7,178 participants. According to the results, after a CRP, there were significant improvements in QoL and Depre scores (Table 1). Moderator variables like psychological intervention in CRP and exercise type were significant for QoL and Depre. Also, CRP duration significantly affected QoL. Table 1. - Global Effect Size and Corrected Effect Size of QoL and Depre in CR patients with CVD Confidence Intervals (95%) DV Model Number of studies Number of ES WES SE CI- CI+ Q(p) I2 Egger’s test (p value) QoL Not corrected 11 14 0,69 0,2172 0,30 1,08 210,189(p<,001) 98.89% 0,002 Corrected 10 12 0,45 0,086 0,20 0,71 146,915(p<,001) 97,31% 0,512 Depre Not corrected 12 14 -0,55 0,1614 -0,89 -0,22 149,931(p<,001) 98,17% 0,011 Corrected 11 12 -0,40 0,0308 -0,56 -0,25 42,114(p<,001) 87,43% 0,123 Conclusions: In conclusion, this meta-analytical review reaffirms the positive psychological effects on QoL and Depre following a CRP.