Observational studyOpen heart2026
Are clinical improvements in anxiety or depression associated with improvement in walking fitness following a cardiac rehabilitation programme?
Observational study in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
objectiveTo investigate whether achieving minimum clinically important difference in anxiety and depression is associated with meeting minimum clinically important difference in walking fitness following cardiac rehabilitation.
methodsThis retrospective observational study analysed routinely collected data from the UK National Audit of Cardiac Rehabilitation. Univariate analyses were employed to investigate the baseline characteristics associated with walking fitness. Then, a logistic regression analysis was conducted to examine whether achieving the minimum clinically important difference in anxiety and depression (defined as >1.7 score improvement in the Hospital Anxiety and Depression Scale) was associated with achieving the minimum clinically important difference in walking fitness (defined as >70 m improvement in the incremental shuttle walk test) following cardiac rehabilitation.
resultsA total of 4585 acute coronary syndrome patients at the National Audit of Cardiac Rehabilitation underwent valid incremental shuttle walk test and the Hospital Anxiety and Depression Scale assessments before and after cardiac rehabilitation between 1 January 2021 and 30 June 2024. Patients who achieved the minimum clinically important difference for depression had 23% higher odds of meeting the minimum clinically important difference for walking fitness (OR 1.23, 95% CI 1.01 to 1.49). Compared with home-based programmes, centre-based group programmes and hybrid programmes (combining centre-based and home-based components) were associated with higher odds of achieving clinically meaningful improvement in walking fitness. Factors such as older age, female sex, physical inactivity, obesity and longer waiting times to commence cardiac rehabilitation were associated with a lower likelihood of achieving minimum clinically important difference in walking fitness, adjusting for baseline anxiety, depression and incremental shuttle walk test scores.
conclusionClinically meaningful improvement in depressive symptoms was associated with clinically meaningful improvement in walking fitness, underscoring the relevance of addressing depression within cardiac rehabilitation.
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