A multicenter intervention study on referral to cardiac rehabilitation after coronary artery bypass graft surgery: a 1-year follow-up of rehabilitation rates among USSR-born and veteran Israeli patients.

Despite evidence on the benefits of participating in cardiac-rehabilitation (CR) following coronary artery bypass graft (CABG) surgery and the inclusion of CR in the basic "Health Basket", referral and uptake of CR in Israel remain low. To assess the CR participation rate and CR-related outcomes 1-year following CABG-surgery among patients born in the former Soviet Union and veteran-Israelis. An interventional trial was conducted in which 489 and 472 CABG patients from 5 cardiothoracic wards across Israel were interviewed in hospital before surgery, and at home a year later for the control arm and the intervention arm respectively. The intervention included dissemination of information on CR to medical staff and patients. USSR-born patients constituted 22.5% of the sample. They were one year older than veteran-Israelis (median-age: 68 and 67 years, respectively, p = 0.2), had a larger proportion of women (31.5% vs. 22.4% respectively, p = 0.006), and a larger proportion of widows (20.0% vs. 13.6%, respectively, p = 0.02). Following the intervention, the CR participation rate of veteran-Israeli males increased from 24.6% to 40.4% (p < 0.001), and that of USSR-born males increased from 3.7% to 13.4% (p = 0.037). No USSR-born female participated in CR, while participation rates of veteran-Israeli females increased from 14.6% to 26.9%, p = 0.056. CR participants reported better health-related quality of life and higher levels of cardio-respiratory fitness (p < 0.001) at follow-up, compared to patients who did not participate in CR. The intervention was effective in increasing the participation in CR programs among all but USSR-born females. Further research is needed to assess the needs of this subgroup and develop effective interventions.