PMID- 28727668
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20220409
IS  - 1932-751X (Electronic)
IS  - 1932-7501 (Linking)
VI  - 37
IP  - 6
DP  - 2017 Nov
TI  - Comprehensive Cardiac Rehabilitation for Secondary Prevention After Transient 
      Ischemic Attack or Mild Stroke: PSYCHOLOGICAL PROFILE AND OUTCOMES.
PG  - 428-436
LID - 10.1097/HCR.0000000000000274 [doi]
AB  - PURPOSE: Having previously reported that comprehensive cardiac rehabilitation 
      (CCR) is effective for secondary prevention post-transient ischemic attack 
      (TIA)/mild nondisabling stroke (MNDS), we present psychometric findings for the 
      same sample that elucidate subacute TIA/MNDS psychological outcomes and test 
      whether CCR would be independently associated with psychological improvements. 
      METHODS: In this prospective cohort trial patients with >/=1 risk factor, recruited 
      from a stroke prevention clinic within 12 months (mean = 11.5 weeks) 
      post-TIA/MNDS, entered CCR. RESULTS: Of the 110 recruited patients, 100 (mean age 
      = 65.4 years; 46 females) entered CCR and 80 completed CCR (mean duration = 7.6 
      months). At CCR entry, 16.5% and 39.2% screened positively for depression and 
      anxiety, decreasing nonsignificantly at exit to 4.2%, and significantly to 16.9% 
      (P = .008), respectively. Age-corrected deficits occurred more frequently than 
      expected (P </= .03); at entry, mental health status (13.3%), clock-drawing 
      (31.6%), oral-verbal fluency (16.9%), word-list learning (11.2%), and recall 
      (12.6%); at exit, clock-drawing (30.0%). Entry-to-exit, mean depression, anxiety, 
      mental and physical health status, word-list learning, memory, digit-symbol 
      coding, and oral-verbal fluency scores improved significantly (P </= .031). No 
      reliable change indices were significant. Psychological service recipients 
      improved significantly more than nonrecipients in depression (P = .049). Baseline 
      North American Adult Reading Test score predicted exercise attendance (R = 0.275; 
      P = .044); New York Heart Association (NYHA) class and depression score predicted 
      exit physical health status (R = 0.770, P < .001); and depression score predicted 
      exit mental health status (R = 0.523, P < .001). CONCLUSIONS: Anxiety and 
      executive dysfunction persisted post-TIA/MNDS. Although promising for secondary 
      prevention post-TIA/MNDS, CCR was not independently associated with psychological 
      improvements. CCR psychological treatment may benefit depression. Subacute NYHA 
      class and depression may later affect quality of life.
FAU - Prior, Peter L
AU  - Prior PL
AD  - Cardiac Rehabilitation and Secondary Prevention Program, St Joseph's Hospital, 
      Ontario, Canada (Drs Prior and Suskin and Ms Unsworth); Clinical Neurological 
      Sciences (Drs Hachinski, Chan, and Harnadek) and Southwestern Ontario Stroke 
      Strategy (Ms Mytka), London Health Sciences Centre, Ontario, Canada; Lawson 
      Health Research Institute, Ontario, Canada (Drs Prior and Suskin); Stroke 
      Services, Cardiac Care Network of Ontario, Ontario, Canada (Ms O'Callaghan); and 
      Western University, Ontario, Canada (Drs Hachinski, Chan, Harnadek, and Suskin).
FAU - Hachinski, Vladimir
AU  - Hachinski V
FAU - Chan, Richard
AU  - Chan R
FAU - Unsworth, Karen
AU  - Unsworth K
FAU - Mytka, Sharon
AU  - Mytka S
FAU - Harnadek, Michael
AU  - Harnadek M
FAU - O'Callaghan, Christina
AU  - O'Callaghan C
FAU - Suskin, Neville
AU  - Suskin N
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiopulm Rehabil Prev
JT  - Journal of cardiopulmonary rehabilitation and prevention
JID - 101291247
SB  - IM
MH  - Aged
MH  - Cardiac Rehabilitation/*methods/*psychology
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Ischemic Attack, Transient/*prevention & control/psychology
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Prospective Studies
MH  - Psychometrics
MH  - Risk Factors
MH  - Secondary Prevention/*methods
MH  - Stroke/*prevention & control/psychology
EDAT- 2017/07/21 06:00
MHDA- 2018/07/17 06:00
CRDT- 2017/07/21 06:00
PHST- 2017/07/21 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2017/07/21 06:00 [entrez]
AID - 10.1097/HCR.0000000000000274 [doi]
PST - ppublish
SO  - J Cardiopulm Rehabil Prev. 2017 Nov;37(6):428-436. doi: 
      10.1097/HCR.0000000000000274.