Low Cost Equipment and Short Duration Program Are Not Barriers to Good Outcomes of Cardiac Rehabilitation in Senegalese Patients with Coronary Artery Disease

Abstract

Cardiac rehabilitation is still underused in Africa, despite its cost effectiveness widely demonstrated around the world. Aim: To evaluate the results of a cardiac rehabilitation program in the first Senegalese outpatient center in low resource context. Patients and Method: We carried out a prospective and interventional study. It compared on one hand a group of coronary patients at baseline and after 6 months of our rehabilitation program and on the other hand a control group of patients not enrolled in rehabilitation. Results: We included 70 patients (30 in the rehabilitation group and 40 in the control group). After rehabilitation, the functional capacity improved: 6.99 ± 2.9 Mets at M0 vs 8.8 ± 2.23 Mets at M6, p = 0.0001. Patients of intervention group significantly increased motivation to lifestyle changes and knowledge about their disease. We found better control at 6 months of hypertension (84.50% vs 33.70%, p = 0.003), diabetes (70.00% vs 26.70%, p = 0.0042), LDL cholesterol (33.00% vs 5.00%, p = 0.002) in the group "Rehabilitation". Prevalence of psychosocial issues like anxiety and depression decreased in intervention group: 50.00% at M0 to 23.33% at M3 (p = 0.021), then 30.00% at M6 (p = 0.18). Return to work and resuming sexual activity were not significantly different. Conclusion: Comprehensive cardiac rehabilitation program, with low cost equipment in a short duration, could have real benefits in the management of coronary artery disease by reducing anxiety and depression, improving treatment compliance, control of cardiovascular risk factors, lifestyle changes and disease knowledge.