Back to Search
Start Over
Outcome associated with prescription of cardiac rehabilitation according to predicted risk after acute myocardial infarction: Insights from the FAST-MI registries.
- Source :
-
Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2019 Aug - Sep; Vol. 112 (8-9), pp. 459-468. Date of Electronic Publication: 2019 May 22. - Publication Year :
- 2019
-
Abstract
- Background: Cardiac rehabilitation is strongly recommended in patients after acute myocardial infarction.<br />Aims: To assess cardiac rehabilitation prescription after acute myocardial infarction according to predicted risk, and its association with 1-year mortality, using the FAST-MI registries.<br />Methods: We used data from three 1-month French nationwide registries, conducted 5 years apart from 2005 to 2015, including 13130 patients with acute myocardial infarction admitted to coronary or intensive care units. Atherothrombotic risk stratification was performed using the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention (TRS-2P). Patients were classified into three categories: Group 1 (low risk; no or one risk indicator; score of 0 or 1); Group 2 (intermediate risk; two risk indicators; score of 2); and Group 3 (high risk; at least three risk indicators; score of≥3).<br />Results: Among the 12291 patients, cardiac rehabilitation prescription was 43.6% (49.9% in Group 1; 43.0% in Group 2; 35.2% in Group 3). Using Cox multivariable analysis, cardiac rehabilitation prescription was associated with lower mortality at 1 year in the overall population (3.8% vs. 8.2%; hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.61-0.85; P<0.001). Cardiac rehabilitation was associated with improved 1-year mortality, with homogeneous relative risk reductions in low- and intermediate-risk categories (HR 0.70, 95% CI 0.51-0.94) compared with high-risk patients (HR 0.72, 95% CI 0.59-0.88). In absolute terms, however, mortality decrease associated with cardiac rehabilitation was positively correlated with risk level (Group 1, 0.9% vs. 2.4%; Group 2, 3.0% vs. 4.2%; Group 3, 10.5% vs. 17.3%).<br />Conclusion: Cardiac rehabilitation prescription was inversely correlated with patient risk. A positive association between cardiac rehabilitation and 1-year survival after acute myocardial infarction was present whatever the risk level, but the greatest mortality reduction was observed in high-risk patients.<br /> (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Female
France
Humans
Male
Middle Aged
Non-ST Elevated Myocardial Infarction diagnosis
Non-ST Elevated Myocardial Infarction mortality
Non-ST Elevated Myocardial Infarction physiopathology
Recovery of Function
Registries
Risk Assessment
Risk Factors
ST Elevation Myocardial Infarction diagnosis
ST Elevation Myocardial Infarction mortality
ST Elevation Myocardial Infarction physiopathology
Time Factors
Treatment Outcome
Cardiac Rehabilitation
Non-ST Elevated Myocardial Infarction rehabilitation
ST Elevation Myocardial Infarction rehabilitation
Subjects
Details
- Language :
- English
- ISSN :
- 1875-2128
- Volume :
- 112
- Issue :
- 8-9
- Database :
- MEDLINE
- Journal :
- Archives of cardiovascular diseases
- Publication Type :
- Academic Journal
- Accession number :
- 31126738
- Full Text :
- https://doi.org/10.1016/j.acvd.2019.04.002