Factors Affecting Return to Work of Patients with Chronic Coronary Syndrome: A Prospective Study.

Background/

Objectives

Return to work is an important goal of cardiac rehabilitation, yet individuals recovering from cardiovascular disease often face significant challenges in achieving it. As a result, a significant proportion of individuals with coronary artery disease experience work disability, negatively impacting both their economic well-being and quality of life while imposing a substantial financial burden on society. This less-studied issue is often treated as a secondary outcome in research, resulting in return to work findings that are frequently underreported. As such, this study aimed to identify the factors associated with adequate levels of functional capacity enabling the engagement in professional work and to develop a model for predicting the potential return to work of patients with coronary artery disease.

Methods

During 2024, we enrolled 250 consecutive patients with chronic coronary syndrome less than 65 years of age who were referred to the National Institute for Medical Assessment and Work Capacity Rehabilitation (INEMRCM) for medical evaluation to establish eligibility-to-work disability benefits. Patients underwent a revascularization procedure either using PTCA or CABG, with a few having had no revascularization until the moment of assessment. Detailed demographic, socioeconomic, and clinical data were collected via interviews. Logistic regression was used to develop a multivariable model for predicting return to work.

Results

Six months after discharge from the INEMRCM, around 20% of participants had returned to work. A better functional status was determinant for individuals' re-employment (p = 0.026) along with an absence of cardiovascular comorbidities (p = 0.045) and holding a higher-skilled occupation (p = 0.037). The multivariate analysis identified professional specialization and the absence of cardiovascular comorbidities as the strongest predictors of return to work.

Conclusions

Cardiac patients with coexisting cardiovascular conditions engaged in less-specialized types of work tend to experience poorer return to work outcomes. As such, individuals in this category should be carefully assessed and prioritized in the development of targeted rehabilitation programs.