Key result
Outpatient cardiac rehabilitation after MI linked to ~47% lower all-cause mortality versus inpatient rehabilitation.
Why the study?
Models of second-phase cardiac rehabilitation following myocardial infarction vary across countries, and outcomes between outpatient and inpatient programs needed comparison.
Does outpatient cardiac rehabilitation reduce mortality and cardiovascular events compared to inpatient cardiac rehabilitation in patients following myocardial infarction?
Cohort (n=96,634)
Yes
Does outpatient cardiac rehabilitation reduce mortality and cardiovascular events compared to inpatient cardiac rehabilitation in patients following myocardial infarction?
Effect estimate: HR 0.53 (95% CI 0.38-0.74)
In patients following myocardial infarction, participation in outpatient cardiac rehabilitation is associated with a lower risk of mortality and cardiovascular events compared to inpatient programs.
May support preferring outpatient over inpatient cardiac rehabilitation post-MI; leaves open whether randomized trials confirm mortality benefit.
Background: Models of second-phase cardiac rehabilitation (CR) following myocardial infarction (MI) differ across countries. The aim of this study was to compare outcomes in MI survivors participating in outpatient and inpatient CR programs. Methods: All patients hospitalized for acute MI in Poland between October 2017 and December 2018 (n = 96,634) were included in the study. Among them, 4411 patients were referred to and commenced outpatient CR, whereas 11,626 patients started inpatient CR within 30 days following discharge. Results: The mean follow-up period was 332.8 ± 128.1 days. Younger age, male sex, and a history of cancer were associated with a higher probability of participating in outpatient CR, whereas diabetes, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, ST-elevation MI, and myocardial revascularization were associated with a lower likelihood of outpatient CR participation. Participation in outpatient CR was linked to a reduced risk of all-cause mortality, in both univariable (hazard ratio [95% confidence interval]: 0.37 [0.26–0.51]) and multivariable analyses (0.53 [0.38–0.74]). Outpatient CR was also associated with a lower risk of death, MI, or stroke (0.57 [0.48–0.67] in univariable analysis and 0.72 [0.61–0.84] in multivariable analysis), as well as a lower risk of death or cardiovascular hospitalization (0.78 [0.73–0.84] and 0.85 [0.80–0.91], respectively). Conclusions: Outpatient CR following MI tends to occur alongside a better prognosis compared to inpatient programs.
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Jankowski et al. (2025) conducted a cohort in Acute myocardial infarction (n=96,634). Outpatient cardiac rehabilitation vs. Inpatient cardiac rehabilitation was evaluated on All-cause mortality (HR 0.53, 95% CI 0.38-0.74). Outpatient cardiac rehabilitation following myocardial infarction was associated with a reduced risk of all-cause mortality compared to inpatient rehabilitation (HR 0.53; 95% CI 0.38-0.74).
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