TY - JOUR
T1 - Cardiac rehabilitation and outcome in stable outpatients with recent myocardial infarction
AU - Coll-Fernández, Roser
AU - Coll, Ramon
AU - Pascual, Teresa
AU - Sánchez Muñoz-Torrero, J. Francisco
AU - Sahuquillo, Joan Carles
AU - Manzano, Luis
AU - Aguilar, Eduardo
AU - Alcala-Pedrajas, José N.
AU - Álvarez, Lorenzo Ramón
AU - García-Díaz, Ana María
AU - Mujal, Abel
AU - Yeste, Montserrat
AU - Monreal, Manuel
PY - 2014/2/1
Y1 - 2014/2/1
N2 - 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. © 2014 by the American Congress of Rehabilitation Medicine.
AB - 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. © 2014 by the American Congress of Rehabilitation Medicine.
KW - CI
KW - confidence interval
KW - FRENA
KW - List of abbreviations
KW - MI
KW - myocardial infarction
KW - Risk Factors and Arterial Disease
U2 - 10.1016/j.apmr.2013.09.020
DO - 10.1016/j.apmr.2013.09.020
M3 - Article
SN - 0003-9993
VL - 95
SP - 322
EP - 329
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -