Cardiac Rehabilitation and Outcome in Stable Outpatients With Recent Myocardial Infarction

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• 作者：Roser Coll-Ferná ; ndez ; MD^a ; ^{coll.roser@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ramon Coll ; MD ; PhD^b ; ^c ; ^&lowast ; ; Teresa Pascual ; MD^b ; ^&lowast ; ; J. Francisco Sá ; nchez Muñ ; oz-Torrero ; MD ; PhD^e ; ^&lowast ; ; Joan Carles Sahuquillo ; MD ; PhD^f ; ^&lowast ; ; Luis Manzano ; MD ; PhD^g ; ^&lowast ; ; Eduardo Aguilar ; MD^h ; ^&lowast ; ; José ; N. Alcala-Pedrajas ; MDⁱ ; ^&lowast ; ; Lorenzo Ramó ; n Á ; lvarez ; MD ; PhD^j ; ^&lowast ; ; Ana Marí ; a Garcí ; a-Dí ; az ; MD^k ; ^&lowast ; ; Abel Mujal ; MD^l ; ^&lowast ; ; Montserrat Yeste ; MD^m ; ^&lowast ; ; Manuel Monreal ; MD ; PhD^c ; ^d ; ^&lowast ;
• 关键词：CI ; confidence interval ; FRENA ; Risk Factors and Arterial Disease ; MI ; myocardial infarction
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2014
• 出版时间：February 2014
• 年：2014
• 卷：95
• 期：2
• 页码：322-329
• 全文大小：407 K

文摘

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.