What is the clinical evidence from this study?

Study design: RCT. Population: myocardial infarction (n=512). Intervention: multidomain rehabilitation programme vs. usual care. Primary outcome: composite of cardiovascular death or unplanned hospitalization for cardiovascular causes at 1 year (HR 0.51, 95% CI 0.32-0.82).

What does this research mean for the field?

In older myocardial infarction patients, lower physical performance independently predicts adverse cardiovascular outcomes without altering the beneficial effects of multidomain cardiac rehabilitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether baseline physical performance and its longitudinal changes predict clinical outcomes in older post-myocardial infarction patients undergoing multidomain cardiac rehabilitation.

September 17, 2026European Journal of Preventive Cardiology

Higher baseline physical performance post-MI linked to ~49% lower risk of major cardiovascular events.

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Why the study?

Does baseline physical performance predict outcomes and modify the benefit of multidomain cardiac rehabilitation in older patients after myocardial infarction?

Population

n=512 older patients after myocardial infarction with intermediate Short Physical Performance Battery scores

Comparison

Multidomain cardiac rehabilitation programme vs Usual care

Design

RCT, 2:1 ratio

Follow-up

1 year

Key result

Lower baseline physical performance post-myocardial infarction was associated with a higher risk of cardiovascular death or unplanned cardiovascular hospitalization (HR 0.51; 95% CI 0.32-0.82).

Authors

ARAndrea Raisi VZValentina Zerbini ETElisabetta Tonet

Discussion

Member takes

Overview

Baseline SPPB identifies higher-risk older post-MI patients for closer monitoring; extends prognostic role of physical performance in cardiac rehabilitation.

Key Points

To determine whether baseline physical performance and its longitudinal changes predict clinical outcomes in older post-myocardial infarction patients undergoing multidomain cardiac rehabilitation.
Prespecified subanalysis of the randomized PIpELINe trial (NCT03021044) including 512 patients aged ≥65 years post-myocardial infarction with intermediate Short Physical Performance Battery (SPPB) scores (4–9).
Participants were randomized 2:1 to a multidomain cardiac rehabilitation program or usual care and monitored over a 1-year follow-up.
Associations between baseline SPPB, individual physical performance components, longitudinal changes, and the primary composite outcome (cardiovascular death or unplanned cardiovascular hospitalization) were evaluated using competing-risk models.
Lower baseline SPPB score was independently associated with a higher risk of the primary composite outcome at 1 year (HR 0.51, 95% CI 0.32–0.82).
No significant interaction occurred between baseline physical performance and treatment allocation, demonstrating consistent intervention benefit across functional levels.
Gait speed was the strongest individual prognostic marker, conferring a roughly 50% risk reduction per 1-point increase (HR 0.50, 95% CI 0.37–0.68; P < 0.001), while an SPPB improvement of ≥1 point over follow-up also predicted fewer adverse events.

Study Design

Type

RCT (n=512)

Randomization

2:1 ratio

Structured PICO

Does baseline physical performance predict outcomes and modify the benefit of multidomain cardiac rehabilitation in older patients after myocardial infarction?

Population

512 older patients (aged ≥65 years) with intermediate physical performance scores (SPPB 4-9) after myocardial infarction, followed for 1 year.

Intervention

Multidomain cardiac rehabilitation programme

Comparator

Usual care

Outcome

Composite of cardiovascular death or unplanned hospitalization for cardiovascular causes at 1 yearcomposite

Main Result

Hazard Ratio: 0.51 (95% CI 0.32–0.82)

In older patients post-myocardial infarction, baseline physical performance (particularly gait speed) is a strong independent predictor of adverse cardiovascular outcomes, and functional improvement over time is associated with better prognosis.

Cite This Study

Raisi et al. (2026) conducted an RCT in myocardial infarction (n=512). multidomain rehabilitation programme vs. usual care was evaluated on composite of cardiovascular death or unplanned hospitalization for cardiovascular causes at 1 year (HR 0.51, 95% CI 0.32-0.82). Lower baseline physical performance post-myocardial infarction was associated with a higher risk of cardiovascular death or unplanned cardiovascular hospitalization (HR 0.51; 95% CI 0.32-0.82).

synapsesocial.com/papers/6aabb8245f706d05830e7bdb https://doi.org/10.1093/eurjpc/zwag390

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September 17, 2026European Journal of Preventive Cardiology

Higher baseline physical performance post-MI linked to ~49% lower risk of major cardiovascular events.

View Full Paper

Ask AI

Bookmark

Why the study?

Does baseline physical performance predict outcomes and modify the benefit of multidomain cardiac rehabilitation in older patients after myocardial infarction?

Population

n=512 older patients after myocardial infarction with intermediate Short Physical Performance Battery scores

Comparison

Multidomain cardiac rehabilitation programme vs Usual care

Design

RCT, 2:1 ratio

Follow-up

1 year

Key result

Lower baseline physical performance post-myocardial infarction was associated with a higher risk of cardiovascular death or unplanned cardiovascular hospitalization (HR 0.51; 95% CI 0.32-0.82).

Authors

ARAndrea Raisi VZValentina Zerbini ETElisabetta Tonet

Discussion

Member takes

Overview

Baseline SPPB identifies higher-risk older post-MI patients for closer monitoring; extends prognostic role of physical performance in cardiac rehabilitation.

Key Points

To determine whether baseline physical performance and its longitudinal changes predict clinical outcomes in older post-myocardial infarction patients undergoing multidomain cardiac rehabilitation.
Prespecified subanalysis of the randomized PIpELINe trial (NCT03021044) including 512 patients aged ≥65 years post-myocardial infarction with intermediate Short Physical Performance Battery (SPPB) scores (4–9).
Participants were randomized 2:1 to a multidomain cardiac rehabilitation program or usual care and monitored over a 1-year follow-up.
Associations between baseline SPPB, individual physical performance components, longitudinal changes, and the primary composite outcome (cardiovascular death or unplanned cardiovascular hospitalization) were evaluated using competing-risk models.
Lower baseline SPPB score was independently associated with a higher risk of the primary composite outcome at 1 year (HR 0.51, 95% CI 0.32–0.82).
No significant interaction occurred between baseline physical performance and treatment allocation, demonstrating consistent intervention benefit across functional levels.
Gait speed was the strongest individual prognostic marker, conferring a roughly 50% risk reduction per 1-point increase (HR 0.50, 95% CI 0.37–0.68; P < 0.001), while an SPPB improvement of ≥1 point over follow-up also predicted fewer adverse events.

Study Design

Type

RCT (n=512)

Randomization

2:1 ratio

Structured PICO

Does baseline physical performance predict outcomes and modify the benefit of multidomain cardiac rehabilitation in older patients after myocardial infarction?

Population

512 older patients (aged ≥65 years) with intermediate physical performance scores (SPPB 4-9) after myocardial infarction, followed for 1 year.

Intervention

Multidomain cardiac rehabilitation programme

Comparator

Usual care

Outcome

Composite of cardiovascular death or unplanned hospitalization for cardiovascular causes at 1 yearcomposite

Main Result

Hazard Ratio: 0.51 (95% CI 0.32–0.82)

Cite This Study

synapsesocial.com/papers/6aabb8245f706d05830e7bdb https://doi.org/10.1093/eurjpc/zwag390

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