Cardiac event rate in a lifestyle modification program for patients with chronic coronary artery disease.

BACKGROUND

Several clinical trials have shown that intensive lifestyle modification programs have a significant impact on cardiovascular risk factors.

HYPOTHESIS: This paper is a retrospective analysis to determine the effect of participation in a 2-year lifestyle management program on long-term clinical outcome in patients outside the setting of a clinical trial.

METHODS

Patients with angiographically confirmed coronary artery disease (CAD) enrolled in a 2-year program of exercise training, dietary counseling, stress management, and therapeutic education. They were accepted into the program from 1991 through December 2002. Follow-up after completion of the program ranged from 10 to 2 years.

RESULTS

In all, 134 patients enrolled in the program; of these, 77 completed the program and 57 failed to do so. Those who completed the program improved their effort tolerance and reached recommended goals for serum lipid and blood pressure levels. The cumulative event rate (cardiac death, myocardial infarction, and stroke) over 10 years in the patients who completed the program was 1.5%. The corresponding event rate in patients who dropped out was 18% (p < 0.02).

CONCLUSIONS

It is suggested that patients who complete a 2-year lifestyle modification program appear to have a favorable prognosis over an extended period of time.