Key result
Attending exercise-based cardiac rehabilitation was associated with significantly larger improvements in cardiovascular risk factors at one-year post myocardial infarction, including higher rates of smoking cessation and increased physical activity.
Why the study?
Whether exercise-based cardiac rehabilitation provides the same favourable effects on cardiovascular risk factors in real-life settings in the modern era of myocardial infarction treatment is less well known.
Does attending exercise-based cardiac rehabilitation improve cardiovascular risk factors at one-year post myocardial infarction?
Cohort (n=19,136)
Yes
Does attending exercise-based cardiac rehabilitation improve cardiovascular risk factors at one-year post myocardial infarction?
Absolute Event Rate: 64% vs 50%
p-value: p=<0.001
In a real-world registry cohort, attending exercise-based cardiac rehabilitation post-myocardial infarction was associated with significant improvements in cardiovascular risk factors at one year.
May support post-MI cardiac rehabilitation referral; extends prior trials to real-world cohorts but leaves causality open.
BACKGROUND: Randomized trials confirm the benefits of exercise-based cardiac rehabilitation on cardiovascular risk factors. Whether exercise-based cardiac rehabilitation provides the same favourable effects in real-life cardiac rehabilitation settings, in the modern era of myocardial infarction treatment, is less well known. We examined the association between attending exercise-based cardiac rehabilitation and improvements in cardiovascular risk factors at one-year post myocardial infarction in patients included in the Swedish heart disease registry, SWEDEHEART. METHODS: In this retrospective registry-based cohort study, we included 19 136 patients post myocardial infarction (75% men, 62.8±8.7 years) who were registered in SWEDEHEART between 2011 and 2013. The association between attending exercise-based cardiac rehabilitation (43% participation rate) and changes in cardiovascular risk profile between baseline and one-year follow-up was assessed using multivariable regression analysis adjusting for age, comorbidities and medication. RESULTS: Attenders more often reported to have stopped smoking (men 64% vs 50%; women 64% vs 53%, p<0.001 for both, only smokers at baseline considered), be more physically active (men 3.9±2.5 vs 3.4±2.7 days/week; women 3.8±2.6 vs 3.0±2.8 days/week, p<0.001 for both) and achieved a slightly larger reduction in triglycerides (men -0.2±0.8 vs -0.1±0.9 mmol/L, p = 0.001; women -0.1±0.6 vs 0.0±0.8 mmol/L, p = 0.01) at one-year compared to non-attenders. Male attenders gained less weight (+0.0±5.7 vs +0.3±5.7 kg, p = 0.01) while female attenders achieved better lipid control (total cholesterol -1.2±1.4 vs -0.9±1.4 mmol/L, p<0.001; low-density lipoprotein -1.2±1.2 vs -0.9 ±1.2 mmol/L, p<0.001) compared to non-attenders. CONCLUSIONS: In an unselected registry cohort of patients post myocardial infarction, compared to non-attenders those attending exercise-based cardiac rehabilitation achieved significantly larger improvements in cardiovascular risk factors at one-year after the acute event.
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Sjölin et al. (2020) conducted a cohort in Myocardial infarction (n=19,136). Exercise-based cardiac rehabilitation vs. Non-attendance of exercise-based cardiac rehabilitation was evaluated on Smoking cessation at one year (men) (p=<0.001). Attending exercise-based cardiac rehabilitation was associated with significantly larger improvements in cardiovascular risk factors at one-year post myocardial infarction, including higher rates of smoking cessation and increased physical activity.
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