Key result
Multidomain cardiac rehabilitation cuts CV death or unplanned CV hospitalization ~43% in frail post-MI patients.
Why the study?
Frailty is common after myocardial infarction and often perceived as a barrier to cardiac rehabilitation, but whether it influences prognosis and modifies the clinical benefit of multidomain cardiac rehabilitation remained unclear.
Does multidomain cardiac rehabilitation reduce cardiovascular death or unplanned cardiovascular hospitalization in older patients recovering from myocardial infarction, including those who are frail?
RCT (n=512)
2:1
Does multidomain cardiac rehabilitation reduce cardiovascular death or unplanned cardiovascular hospitalization in older patients recovering from myocardial infarction, including those who are frail?
Hazard Ratio: 0.57 (95% CI 0.34–0.94)
p-value: p=0.028
Multidomain cardiac rehabilitation significantly reduces the risk of cardiovascular death or unplanned cardiovascular hospitalization in older patients recovering from myocardial infarction, and this benefit is maintained in prefrail and frail patients.
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“My hope is that these findings will encourage us to think a little more openly about who we refer to cardiac rehab and not be necessarily biased against patients because they're more frail. We talk to a lot of cardiac rehab professionals, and their general opinion is: 'Send us everybody and we'll figure out whether or not they're a good fit.'”
Supports multidomain cardiac rehabilitation in frail post-MI patients; extends evidence to this high-risk subgroup.
Passo et al. (2026) conducted an RCT in Myocardial infarction (n=512). Multidomain cardiac rehabilitation vs. Usual care was evaluated on Composite of cardiovascular death or unplanned hospitalization for cardiovascular causes within 1 year (HR 0.57, 95% CI 0.34-0.94, p=0.028). Multidomain cardiac rehabilitation reduced cardiovascular death or unplanned cardiovascular hospitalization in frail patients post-myocardial infarction (HR 0.57; 95% CI 0.34-0.94; P=0.028).