72% do not attend cardiac rehabilitation after PCI

Several thousand Norwegian patients with coronary artery disease have answered Siv Jorunn Storli Olsen‘s questions about cardiac rehabilitation, anxiety, depression and employment status.


  1. Only 28% of patients attend cardiac rehabilitation following PCI.
  2. Anxiety and depression are higher among cardiac rehabilitation participants than non-participants.
  3. Cardiac rehabilitation does not seem to influence employment status three years after PCI.


Thesis: Coronary heart disease and cardiac rehabilitation. Participation rate, predictors and effects on symptoms of anxiety and depression, and employment status of patients following percutaneous coronary intervention – A nationwide prospective cohort study
Candidate: Siv Jorunn Storli Olsen
Time: April 3, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website (in Norwegian)


(1) Cardiac rehabilitation participation is low following percuteneous coronary intervention in Norway. There are substantial regional differences. In total, 28% of patients participate within three years of PCI. In Northern and Western Norway only 20% participate, compared to 31% in Central and South-Eastern Norway.

More than 7000 patients treated with PCI between 2008 and 2012 took part in the questionnaire-based study. Women were more likely to attend cardiac rehabilitation than men. Young age, higher education and overweight were also predictors of attendance. Moreover, patients with stable angina participated less frequently than patients with acute coronary artery disease.

(2) PCI patients attending cardiac rehabilitation have higher baseline levels of anxiety and depression than non-participants. These differences are still prevalent after three years follow-up. Both groups have more anxiety than the general population.

More than 9000 patients who underwent their first PCI were included. Women and younger patients were more likely to have anxiety. Older persons with low levels of education were more likely to have depression.

(3) 30 % of PCI patients of working age are unemployed three years after the event. Participation in cardiac rehabilitation is not associated with long-term employment status. Young, non-smoking men of higher education who are living with a partner have higher chance of being employed.

The study includes almost 2500 patients who were younger than 60 years at baseline. Cardiac rehabilitation participants were compared with propensity score-matched patients that did not attend cardiac rehabiliation.


(1) Olsen, S. J., Schirmer, H., Bønaa, K. H., & Hanssen, T. A. (2018). Cardiac rehabilitation after percutaneous coronary intervention: results from a nationwide surveyEuropean Journal of Cardiovascular Nursing17(3), 273-279.

(2) Olsen, S. J., Schirmer, H., Wilsgaard, T., Bønaa, K. H., & Hanssen, T. A. (2018). Cardiac rehabilitation and symptoms of anxiety and depression after percutaneous coronary intervention. European journal of preventive cardiology25(10), 1017-1025.

(3) Olsen, S. J., Schirmer, H., Wilsgaard, T., Bønaa, K. H., & Hanssen, T. A. (2020). Employment status three years after percutaneous coronary intervention and predictors for being employed: A nationwide prospective cohort studyEuropean Journal of Cardiovascular Nursing, 1474515120903614.

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