A low SYNTAX score (<22) and complete revascularization significantly increased return to work within 6 months post-ACS, while high SYNTAX (>32) tripled 1-year MACE risk.
Does complete revascularization and lower SYNTAX score improve return to work rates in patients after a first acute coronary syndrome?
Lower coronary disease complexity (SYNTAX <22) and complete revascularization predict faster return to work after ACS, which is associated with improved 12-month cardiovascular outcomes.
Absolute Event Rate: 0% vs 0%
Abstract Background Return to work (RTW) after an acute coronary syndrome (ACS) is a crucial aspect of the recovery process, particularly in younger individuals. Several clinical, angiographic, and socioeconomic factors influence RTW, including left ventricular ejection fraction (LVEF), cardiovascular risk factors (CVRF), the complexity of coronary artery disease (CAD) assessed by the SYNTAX score, and the type of revascularization performed. Identifying these factors can improve rehabilitation and long-term cardiovascular outcomes. Objective To determine the timeframe for RTW, identify independent predictive factors, and assess the impact of complete revascularization on post-ACS outcomes. Methods We conducted a prospective, single-center study including 129 patients hospitalized for a first ACS episode. All had been professionally active for at least six months before the event. Data collection covered demographics, CVRF, clinical severity (Killip, LVEF), angiographic findings (SYNTAX, number of diseased vessels), revascularization status (angioplasty vs coronary bypass), comorbidities, and quality-of-life assessments. Patients were stratified by SYNTAX score into three groups: low 22, intermediate 23-32, and high 32. Follow-ups at 1, 3, 6, and 12 months assessed RTW and cardiovascular events (MACE). Results The mean age was 51.5 ± 6.4 years. RTW occurred in 84% of patients within six months. Univariate analysis identified several factors favoring RTW: LVEF ≥45% (p=0.001), Killip I (p=0.009), absence of in-hospital complications (p=0.044), lower smoking history (p=0.025), stable employment (p=0.05), and higher physical activity levels (p=0.001). A low SYNTAX score 22 was strongly associated with faster RTW (p=0.028), while intermediate or high scores correlated with delayed RTW. Patients undergoing complete revascularization showed a significantly higher RTW rate (p=0.039) compared to those with incomplete revascularization. Multivariate analysis confirmed that having fewer than three dependent children (OR=7.7; p=0.046) was an independent factor associated with faster RTW. Conversely, diabetes (OR=0.52; p=0.041), chronic kidney disease (OR=0.49; p=0.037), and obesity (OR=0.56; p=0.045) were independently linked to delayed RTW. Long-Term Prognostic Impact: At 12 months, early RTW was associated with a significantly lower incidence of MACE (p=0.022), including recurrent ACS, heart failure, and cardiovascular mortality. Notably, patients with high SYNTAXs 32 had a threefold higher MACE rate at one year (p=0.015), reinforcing the prognostic value of CAD complexity. Conclusion Clinical, angiographic, and socioeconomic factors influence RTW after ACS. High SYNTAX scores, incomplete revascularization, or comorbidities require extended rehabilitation. Early RTW is associated with improved prognosis, emphasizing its role in post-ACS care. A multidisciplinary, patient-centered approach could enhance RTW rates and overall cardiac health.MACE-Free Survival Rate Over 12 Months B
Lahnaoui et al. (Sat,) reported a other. A low SYNTAX score (<22) and complete revascularization significantly increased return to work within 6 months post-ACS, while high SYNTAX (>32) tripled 1-year MACE risk.