Article

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.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS