{
  "abstract": "Introduction Cardiac rehabilitation (CR) has been shown to improve outcomes 1. However, differences in outcomes between ethnic groups remains unknown. Aim: to investigate change in functional capacity and psychological outcomes of CR, comparing South Asian and White European patients in the UK.Methods Data from the National Audit of Cardiac Rehabilitation (NACR) identified South Asian and White European patients who completed CR between Jan 2014 and Jan 2023. Initiating events included myocardial infarction, percutaneous coronary intervention and coronary artery bypass. Functional capacity was assessed by distance in the incremental shuttle walk test (ISWT) or 6-minute walk test (6MWT). Psychological measures included Hospital Anxiety and Depression Scale (HADS) scores. Pre- and post-CR score changes were reported as mean or median values according to their distribution. Linear and quantile regression models estimated differences in mean or median score changes, and logistic regression estimated the relative odds of achieving a minimal clinically important difference (MCID) following CR.Results From 490,646 eligible individuals, 268,264 (56%) started CR, of which 205,879 (77%) completed it and 98,615 (48%) had available pre and post scores. South Asian patients were younger (mean age 60 years [SD±11]) fewer and less likely to be female (18%) compared to the White European patients (mean age 66 year [SD±11]; 23% female). South Asians had lower functional capacity pre-and post-CR, with similar or less improvement than White Europeans (ISWT median +80m [IQR 30–150] versus +90m [IQR 40–160]; 6MWT +60m [IQR 22–100] versus +60m [IQR 25–100]). After adjustment for pre-CR score, age, sex, index of multiple deprivation and co-morbidities, there were significantly smaller gains in walking distance among South Asians for both ISWT and 6MWT, compared to White Europeans (ISWT median change -17.85m [95% CI -32.1, -12.6]; 6MWT -7.28m [95% CI -12.47, -2.09]) and lower odds of achieving MCID: ISWT; OR 0.70 (95% CI 0.63, 0.7); 6MWT OR 0.72 (95% CI 0.60, 0.87, figure 1). Psychologically, South Asians had worse pre- and post-CR anxiety and depression scores compared to White Europeans but similar improvement (HADS depression mean -0.9 [SD±3.5] versus -0.9 [SD±2.9]; HADS anxiety -0.8 [SD±3.7] versus -0.7 [SD±3.0]. After adjustment, South Asian patients showed some evidence of slightly better improvement in these measures and were more likely to achieve MCID on anxiety and depression scores than White European patients (HAD Anxiety OR 1.21 [CI 1.12, 1.31]; HAD Depression OR 1.48 [CI 1.37, 1.61], figure 1).Conclusion CR improved functional capacity and psychological measures in both groups, though South Asian patients experienced less improvement in physical outcomes yet greater improvement in anxiety and depression scores than White European patients. Tailoring of exercise training and psychological support for specific groups could optimise cardiac rehabilitation benefits.Abstract 3-009 Figure 1Difference in a) median and mean change and b) odds of achieving MCID, in functional capacity and psychological measures following completion of cardiac rehabilitation, comparing South Asian to White EuropeanKey: MICD: minimal important clinical difference; ISWT: incremental shuttle walk test; 6MWT: six minute walk test; HADS: hospital anxiety and depression scale. Median change was estimated using quantile regression and mean change by linear regression. Odds of achieving MCID were estimated using logistic regression. Estimates comparing South Asian patients with White European patients are presented alongside 95% confidence intervals. All models were adjusted for pre-CR scores, age at initiating event, sex, index of multiple deprivation and co-morbidities, including number (0, 1–2, >2) and type (angina, arthritis, cancer, diabetes, rheumatism, stroke, osteoporosis, hypertension, chronic bronchitis, emphysema, asthma, claudication, chronic back pain, anxiety, depression family history, erectile dysfunction and hyperlipidaemia).",
  "authors": [
    {
      "affiliations": [
        "Respiratory Department, University of Leicester, Leicester",
        "Centre for Exercise and Rehabilitation Science (CERS), Leicester Biomedical Research Centre (Respiratory), Glenfield Hospital, Groby Road, Leicester"
      ],
      "name": "Joanne McAllister"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Sciences, University of Leicester, Leicester",
        "Leicester Biomedical Research Centre (Cardiovascular), Glenfield Hospital, Groby Road, Leicester"
      ],
      "name": "Claire A Lawson"
    },
    {
      "affiliations": [
        "National Audit of Cardiac Rehabilitation, University of York, York, UK"
      ],
      "name": "Alex Harrison"
    },
    {
      "affiliations": [
        "National Audit of Cardiac Rehabilitation, University of York, York, UK"
      ],
      "name": "Patrick Doherty"
    },
    {
      "affiliations": [
        "Respiratory Department, University of Leicester, Leicester",
        "Centre for Exercise and Rehabilitation Science (CERS), Leicester Biomedical Research Centre (Respiratory), Glenfield Hospital, Groby Road, Leicester"
      ],
      "name": "Sally J Singh"
    }
  ],
  "title": "3-009 Functional capacity and psychological outcomes following completion of cardiac rehabilitation by ethnicity: insights from the national audit of cardiac rehabilitation",
  "uid": "53da511f-ec14-56d0-9c21-b9a7b86b4d58"
}