Article

The prognostic effect of early, comprehensive short-term cardiac
rehabilitation on top of current, guideline-adjusted treatment of acute
myocardial infarction has not sufficiently been evaluated.
DESIGN: Prospective
cohort study. METHODS: Within the OMEGA study population, the clinical course of
3560 patients still alive 3 months after acute myocardial infarction were
evaluated by comparing patients who had attended to cardiac rehabilitation
(70.6%) with those who did not. Total mortality and major adverse cerebrovascular
and cardiovascular events, as well as non-fatal events, were evaluated within the
time period of 4-12 months after hospital admission for acute myocardial
infarction. The effect of cardiac rehabilitation on clinical events was estimated
by using the propensity score method to adjust for confounding parameters in
multivariate analysis. RESULTS: Patients participating in cardiac rehabilitation
were younger, more often had acute revascularization, less often experienced
non-ST-elevation myocardial infarction, and less often had a history of diabetes
or cardiovascular events. Total mortality (OR 0.46, 95% CI 0.27-0.77) and major
adverse cerebrovascular and cardiovascular events (OR 0.53, 95% CI 0.38-0.75)
were significantly lower in the rehabilitation group. Subgroup analysis including
major clinical characteristics also revealed significantly reduced rates of total
death and major adverse cerebrovascular and cardiovascular events in the
rehabilitation group. CONCLUSIONS: Attendance to early, comprehensive short-term
cardiac rehabilitation programmes on top of current guideline-adjusted treatment
of acute myocardial infarction is associated with a significantly improved 1-year
prognosis.
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Langue : ANGLAIS