Younger age (<50 years) was strongly associated with increased participation in cardiac rehabilitation compared to older age (>70 years) after primary percutaneous coronary intervention (OR 7.0).
Observational (n=3,871)
No
Only a minority (39%) of AMI patients treated with pPCI participate in cardiac rehabilitation, with elderly, women, and low socio-economic status patients being particularly underrepresented, highlighting the need for targeted awareness and referral strategies.
Odds Ratio: 7 (95% CI 5.1–9.6)
Absolute Event Rate: 58.4% vs 17%
p-value: p=<0.001
BACKGROUND: Hospital length of stay after acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) has reduced, resulting in more limited patient education during admission. Therefore, systematic participation in cardiac rehabilitation (CR) has become more essential. We aimed to identify patient-related factors that are associated with participation in and completion of a CR programme. METHODS: We identified 3,871 consecutive AMI patients who underwent pPCI between 2003 and 2011. These patients were linked to the database of Capri CR, which provides dedicated, multi-disciplinary CR. 'Participation' was defined as registration at Capri CR within 6 months after pPCI. CR was 'complete' if a patient undertook the final exercise test. RESULTS: In total, 1,497 patients (39%) were registered at Capri CR. Factors independently associated with CR participation included age (70 year: odds ratio (OR) 7.0, 95% confidence interval (CI) 5.1-9.6), gender (men vs. women: OR 1.9, 95% CI 1.3-1.8), index diagnosis (ST-elevation myocardial infarction STEMI vs. non-ST-elevation myocardial infarction NSTEMI: OR 2.4, 95% CI 2.0-2.7) and socio-economic status (high vs. low: OR 2.0, 95% CI 1.6-2.5). The model based on these factors discriminated well (c-index 0.75). CR programme completion was 80% and was inversely related with diabetes, current smoking and previous MI. The discrimination of the model based on these factors was poor (c-index 0.59). CONCLUSIONS: Only a minority of AMI/pPCI patients participated in a CR programme. Completion rates, however, were better. Increased physician and patient awareness of the benefits of CR are still needed, with focus on the elderly, women and patients with low socio-economic status.
Sunamura et al. (Fri,) conducted a observational in Acute myocardial infarction treated with primary percutaneous coronary intervention (n=3,871). Age <50 years vs. Age >70 years was evaluated on Cardiac rehabilitation participation (registration within 6 months after pPCI) (OR 7.0, 95% CI 5.1-9.6, p=<0.001). Younger age (<50 years) was strongly associated with increased participation in cardiac rehabilitation compared to older age (>70 years) after primary percutaneous coronary intervention (OR 7.0).
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