Referral to cardiac rehabilitation was independently associated with a lower risk of persistent smoking (OR 0.60) and insufficient physical exercise (OR 0.70) at six months post-AMI.
Observational (n=11,706)
Yes
Do post-discharge cardiac visits and referral to cardiac rehabilitation improve adherence to healthy lifestyles in patients 6 months after acute myocardial infarction?
Six months post-AMI, drug adherence is high but risk factor control remains suboptimal, while post-discharge cardiac visits and rehabilitation referral are associated with better adherence to healthy lifestyles.
Odds Ratio: 0.6
BACKGROUND: To describe drug adherence and treatment goals, and to identify the independent predictors of smoking persistence and unsatisfactory lifestyle habits six months after an acute myocardial infarction (AMI). METHODS AND RESULTS: 11,706 patients with AMI (30% female, mean age 68 years) were enrolled in 163 large-volume coronary care units (CCUs). At six months, drug adherence was ≥90%, while blood pressure (BP) <140/90 mmHg, low density lipoprotein (LDL) <100 mg/dl (in patients on statins), HbA1c <7% (in treated diabetics), and smoking persistence were observed in 74%, 76%, 45%, and 27% of patients, respectively. Inadequate fish intake decreased from 73% to 55%, inadequate intake of fruit and vegetables from 32% to 23%, and insufficient exercise in eligible patients from 74% to 59% (p < 0.0001). At multivariable analysis, a post-discharge cardiac visit and referral to cardiac rehabilitation at follow-up were independently associated with a lower risk of insufficient physical exercise (odds ratio (OR) 0.71 and 0.70, respectively) and persistent smoking (OR 0.68 and 0.60), whereas only referral to cardiac rehabilitation was associated with a lower risk of inadequate fish and fruit/vegetable intake (OR 0.70 and 0.65). CONCLUSIONS: Six months after an AMI, despite a high adherence to drug treatments, BP, LDL, and diabetic goals are inadequately achieved. Subjects with healthy lifestyles improved after discharge, but the rate of those with regular exercise habits and adequate fish intake could be further improved. Access to post-discharge cardiac visit and referral to cardiac rehabilitation were associated with better adherence to healthy lifestyles. Knowledge of the variables associated with specific lifestyle changes may help in tailoring secondary prevention programmes.
Urbinati et al. (2014) conducted an observational in Acute myocardial infarction (n=11,706). Referral to cardiac rehabilitation vs. No referral to cardiac rehabilitation was evaluated on Persistent smoking (OR 0.60). Referral to cardiac rehabilitation was independently associated with a lower risk of persistent smoking (OR 0.60) and insufficient physical exercise (OR 0.70) at six months post-AMI.