Cardiopulmonary MedicineORIGINAL ARTICLE

Effects of the Strong Hearts program at two years post program completion

Bruce E. Murphy, MD, PhD; Peyton D. Card, MD; Leybi Ramirez-Kelly, MD; Brandon Wensley, MS; and Robert E. Heidel, PhD
Notes and Affiliations
Notes and Affiliations

Received: April 29, 2024

Accepted: September 10, 2024

Published: October 30, 2024

  • Bruce E. Murphy, MD, PhD, 

    Arkansas Heart Hospital, Little Rock, AR, USA

  • Peyton D. Card, MD, 

    Arkansas Heart Hospital, Little Rock, AR, USA

  • Leybi Ramirez-Kelly, MD, 

    Arkansas Heart Hospital, Little Rock, AR, USA

  • Brandon Wensley, MS, 

    Arkansas Heart Hospital, Little Rock, AR, USA

  • Robert E. Heidel, PhD, 

    University of Tennessee Graduate School of Medicine, Knoxville, TN, USA

Abstract

Context: This is a follow-up to the original published article, Effects of the Strong Hearts Program after a Major Cardiovascular Event in Patients with Cardiovascular Disease.

Objectives: This study evaluated the long-term efficacy of the Strong Hearts program up to 2 years after program completion.

Methods: All study participants who initially completed the Strong Hearts program between 2020 and 2021 (n=128) were contacted at 12 months and 24 months following the date of program completion. A phone survey was conducted to see if any significant post-cardiovascular events or readmissions to the hospital occurred, and self-reported dates of any occurrences were recorded. Hospital readmissions and cardiac-related procedures were cross-referenced with the hospital’s electronic medical record. A chi-square goodness-of-fit analysis was utilized to compare the observed rates of categorical outcomes vs. expected rates yielded from the empirical literature.

Results: The rate of all-cause readmission at 6 months post-program completion was 2/120 (1.7 %), compared to the expected rate of 50 %, χ2(1) = 112.13, p<0.001. The readmission rate at 1 year post-program completion was 17/120 (14.2 %), vs. the expected rate of 45 %, χ2(1) = 46.09, p<0.001, and at 2 years post-program completion, the readmission rate was 24/120 (20.0 %) compared to the expected rate of 53.8 %, χ2(1) = 56.43, p<0.001. Ten participants (8.3 %) had a subsequent cardiac procedure within 2 years of completing the program, including two requiring percutaneous coronary intervention (1.7 %) and eight requiring coronary artery bypass grafting (CABG, 6.7 %), compared to the expected rates of 13.4 and 57.74 %, χ2(1)=153.08, p<0.001, respectively. Mortality at 2 years post-program completion was 2/128 (1.6 %), compared to 23.4 %, χ2(1)=34.13, p<0.001.

Conclusions: Efficacy of the Strong Hearts program continued at 6 months, 1 year, and 2 years post-program completion in terms of all-cause readmission, subsequent cardiac event, and all-cause mortality.

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