Predictors of cardiac rehabilitation completion after acute myocardial infarction in young women: the French WAMIF Registry

Aims Cardiac rehabilitation (CR) is a cornerstone of secondary prevention after acute myocardial infarction (AMI), yet its implementation remains suboptimal, particularly among women. Young women represent an understudied subgroup with distinct presentations and psychosocial vulnerabilities that may influence access to CR. We aimed to identify factors associated with CR completion within 1 year after AMI in young women. Methods and results This exploratory analysis was conducted within the prospective multicentre WAMIF cohort. Women aged <50 years with AMI and available data on CR participation were included. The primary endpoint was CR completion within 1 year. Baseline characteristics were compared according to CR status. Univariable and multivariable logistic regression were used to identify factors independently associated with CR completion. Among 305 young women, 182 (59.7%) completed CR within 1 year after AMI. Age, cardiovascular risk factors, socioeconomic deprivation (EPICES score >30), and prior cardiovascular disease were not significantly different between groups. In univariable analysis, coronary occlusion, ST-elevation myocardial infarction (STEMI), and cardiac arrest were positively associated with CR completion, whereas absence of revascularization and higher LVEF were negatively associated. In multivariable analysis, STEMI remained independently associated with higher odds of CR completion (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.1–3.1; P = 0.019), whereas absence of revascularization was independently associated with lower CR completion (aOR 0.4, 95% CI 0.2–0.8; P = 0.007). Conclusion In young women with AMI, this exploratory analysis showed that CR completion remained suboptimal and was mainly associated with index-event severity and management rather than baseline risk factor burden or social deprivation. Registration WAMIF NCT03073447.