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  1. Jafri, S. Hammad MD, MMSc
  2. Duazo, Catherine MD
  3. Imran, Hafiz MD
  4. Bencie, Nicole N. BA
  5. Imran, Tasnim F. MD, MPH
  6. Ahmad, Khansa MD
  7. Deangelis, Julianne MS
  8. Wu, Wen-Chih MD, MPH


Purpose: Both traditional cardiac rehabilitation (TCR) and intensive cardiac rehabilitation (ICR) have proven benefits for patients with cardiovascular disease. The aim of this study was to compare ICR versus TCR on cardiac rehabilitation (CR) outcomes in patients with cardiovascular disease.


Methods: In a retrospective cohort study of 970 patients (n = 251, ICR; n = 719, TCR) who were referred for CR between January 2018 and December 2019, 693 (71.4%) patients completed it. The TCR sessions were 90 min (60-min exercise) three times/wk for 12 wk, while ICR sessions were 4 hr (60-min exercise) two times/wk for 9 wk. Primary endpoints were change in cardiorespiratory fitness (CRF) (by difference in exercise prescription metabolic equivalents [METs] between the last session and the average of the second and third sessions), anxiety (Generalized Anxiety Disorder-7) scores, percent depression (Patient Health Questionnaire-9 or Center for Epidemiologic Studies Depression Scale) scores, and health status (36-item Short Form Health Survey physical and mental composite scores). Linear regression adjusted for imbalanced baseline characteristics (age, race, and diagnosis of angina).


Results: Of the 693 patients who completed CR (ICR = 204/251 [81%] vs TCR = 489/719 [68%], P < .01), mean age was 66 yr and 31% were female. Patients in TCR had a higher improvement in CRF (CR session METs: ICR +1.5 +/- 1.2 vs TCR +1.9 +/- 1.5, P < .01) but no difference in health status scores. Conversely, patients in ICR had more reduction in anxiety scores (-2 +/- 4 vs -1 +/- 3, P < .01) and percent reduction in depression scores (-8.3 +/- 13.7% vs -5.0 +/- 11.7%, P < .01) than patients in TCR.


Conclusions: Patients in TCR had higher improvement in CRF while patients in ICR had higher improvement in anxiety and depression scores.