Key result
Cardiac rehabilitation after MI is linked to ~84% lower all-cause mortality.
Why the study?
Despite strong recommendations, participation in cardiac rehabilitation after MI remains suboptimal, particularly among vulnerable populations such as the elderly.
Does cardiac rehabilitation participation reduce MACE and all-cause mortality in adults post-myocardial infarction?
Cohort (n=271)
No
Does cardiac rehabilitation participation reduce MACE and all-cause mortality in adults post-myocardial infarction?
Hazard Ratio: 0.16 (95% CI 0.023–0.778)
Absolute Event Rate: 1.2% vs 7.1%
p-value: p=0.023
Cardiac rehabilitation participation following myocardial infarction is associated with a significant reduction in all-cause mortality, though older age and female sex present persistent barriers to participation and completion.
May support post-MI CR referral; leaves open whether mortality reduction is causal or confounded by selection in this observational cohort.
Background Cardiac rehabilitation (CR) is an effective intervention to reduce major cardiac events following myocardial infarction (MI). Despite strong recommendations, participation in CR remains suboptimal. Especially among vulnerable patients like elderly. This study aims to determine contemporary CR participation rates, predictors of non-participation and sex-specific differences at a Dutch general hospital, while evaluating the impact of CR on major adverse cardiac events (MACE) and mortality. Method: A single-center retrospective cohort study included patients admitted to Diakonessenhuis (Utrecht, Netherlands) from December 2019–June 2022. Information regarding CR participation, patient characteristics (e.g. age, sex, medical history), psychological assessments and the incidence of MACE during follow-up were collected from patient files. Result Of 271 included patients, 63.5% participated in CR. Predictors of CR participation included younger age and undergoing coronary artery bypass grafting (CABG). Female patients were older (68.8 vs 64.8 years, p = 0.013), had worse scores on psychological questionnaires during CR and showed lower CR completion rates (71.8% vs 82.0%, p = 0.025) compared to men. CR participation was associated with lower all-cause mortality (HR 0.16, 95% CI 0.02–0.78, p = 0.023) during a median follow-up time of 4.1 years. Conclusion CR participation after MI remains suboptimal. Younger age and CABG are associated with higher participation rates. Female patients show lower CR completion rates and perform worse psychologically. Tailored interventions should address compounded barriers such as older age and possible sex-specific psychosocial burdens.
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Fouw et al. (2026) conducted a cohort in Myocardial Infarction (Acute Coronary Syndrome) (n=271). Cardiac rehabilitation vs. Non-participation in cardiac rehabilitation was evaluated on All-cause mortality (HR 0.16, 95% CI 0.023-0.778, p=0.023). Cardiac rehabilitation participation after myocardial infarction was associated with a significantly lower risk of all-cause mortality (HR 0.16) compared to non-participation over a median follow-up of 4.1 years.
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