Knowledge on cardiovascular risk factors improves the effectiveness of rehabilitation following acute coronary syndrome.

BACKGROUND: There is a clear association between knowledge on healthy lifestyle and intensity of healthy behaviours, especially among young people.

AIM: We sought to verify this hypothesis among patients after acute coronary syndrome (ACS), who were subjected to early in-hospital complex cardiac rehabilitation (CCR), by assessing the relationship between initial knowledge on cardiovascular risk factors and efficiency of rehabilitation.

METHODS: Two hundred and five consecutive patients (153 man; age 62 ± 9 years) hospitalised between May 2013 and April 2014 were prospectively enrolled. On admission, the knowledge on risk factors was assessed by questionnaire. At the beginning, in the second and in the third week of CCR the six-minute walk test (6MWT) was performed. Effectiveness of rehabilitation was assessed by the 6MWT in the third week. Distance, speed, and metabolic equivalents (METs) were consid-ered markers of improvement.

RESULTS: The most common number of correct answers was 11 (out of 20 questions) about risk factors (on average 54 ± 18%). Knowledge on more than 10 items was found for 99 subjects (48%) (i.e. good level of knowledge). Improvement of haemodynamic parameters and CCR effectiveness was found ('0' vs. '3': distance [m]: 442.0 ± 102.2 vs. 485.2 ± 109.3, p < 0.01; speed [km/h]: 4.4 ± 1.0 vs. 4.8 ± 1.1, p < 0.01; METs: 3.1 ± 0.5 vs. 3.3 ± 0.5; p < 0.01). Significantly better indica-tors of CCR effectiveness characterised patients with better knowledge (good knowledge vs. bad knowledge: distance [m]: 500.5 ± 95.7 vs. 470.8 ± 119.4, p = 0.04; speed [km/h]: 5.0 ± 1.0 vs. 4.7 ± 1.2, p = 0.04; METs: 3.4 ± 0.5 vs. 3.2 ± 0.6, p = 0.04). There was correlation between the percentage of correct answers and distance in 6MWT (R = 0.374, p < 0.001).

CONCLUSIONS: Knowledge on the cardiovascular risk factors improves rehabilitation effectiveness among patients after ACS.