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Arch Phys Med Rehabil. 2014 Feb;95(2):322-9. doi: 10.1016/j.apmr.2013.09.020. Epub 2013 Oct 9.

Cardiac rehabilitation and outcome in stable outpatients with recent myocardial infarction.

Author information

  • 1Department of Physical Medicine and Rehabilitation, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Barcelona, Spain. Electronic address: coll.roser@gmail.com.
  • 2Department of Physical Medicine and Rehabilitation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
  • 3Department of Physical Medicine and Rehabilitation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
  • 4Department of Internal Medicine, Hospital San Pedro de Alcántara, Cáceres, Spain.
  • 5Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona, Spain.
  • 6Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  • 7Department of Internal Medicine, Hospital de Alcañiz, Alcañiz, Teruel, Spain.
  • 8Department of Internal Medicine, Hospital Comarcal Valle de los Pedroches, Pozoblanco, Córdoba, Spain.
  • 9Department of Vascular Surgery, Consorci Sanitari de Terrassa-Hospital de Terrassa, Terrassa, Barcelona, Spain.
  • 10Primary Healthcare, Àrea Bàsica de Salut Gaudi, Barcelona, Spain.
  • 11Department of Internal Medicine, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain.
  • 12Department of Angiology and Vascular Surgery, Hospital de Terrassa, Terrassa, Barcelona, Spain.
  • 13Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

Abstract

OBJECTIVE:

To compare the mortality rate and the rate of subsequent ischemic events (myocardial infarction [MI], ischemic stroke, or limb amputation) in patients with recent MI according to the use of cardiac rehabilitation or no rehabilitation.

DESIGN:

Longitudinal observational study.

SETTING:

Ongoing registry of outpatients.

PARTICIPANTS:

Patients (N=1043) with recent acute MI were recruited; of these, 521 (50%) participated in cardiac rehabilitation.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Subsequent ischemic events and mortality rates were registered.

RESULTS:

Over a mean follow-up of 18 months, 50 patients (4.8%) died and 49 (4.7%) developed 52 subsequent ischemic events (MI: n=43, ischemic stroke: n=6, limb amputation: n=3). Both the mortality rate (.16 vs 5.57 deaths per 100 patient-years; rate ratio=.03; 95% confidence interval [CI], 0.0-0.1]) and the rate of subsequent ischemic events (1.65 vs 4.54 events per 100 patient-years; rate ratio=0.4; 95% CI, 0.2-0.7) were significantly lower in cardiac rehabilitation participants than in nonparticipants. Multivariate analysis confirmed that patients in cardiac rehabilitation had a significantly lower risk of death (hazard ratio=.08; 95% CI, .01-.63; P=.016) and a nonsignificant lower risk of subsequent ischemic events (hazard ratio=.65; 95% CI, .30-1.42).

CONCLUSIONS:

The use of cardiac rehabilitation in patients with recent MI was independently associated with a significant decrease in the mortality rate and a nonsignificant decrease in the rate of subsequent ischemic events.

Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

CI; FRENA; MI; Risk Factors and Arterial Disease; confidence interval; myocardial infarction

PMID:
24121084
[PubMed - indexed for MEDLINE]
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