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Cardiac Rehab and Health Status After AMI

JAMA Cardiol; ePub 2016 Oct 19; Kureshi, et al

Publish date:

Reported health status was similar between patients with acute myocardial infarction (AMI) who did and did not participate in cardiac rehabilitation (CR) during the year following AMI; however, participation in CR did demonstrate a significant survival benefit. This according to cohort study of 4,929 patients (3,328 male, 1,601 female; mean age 60 years) with AMI enrolled in 2 AMI registries: PREMIER, from January 1, 2003, to June 28, 2004, and TRIUMPH, from April 11, 2005, to December 31, 2008. Researchers found:

  • Mean differences in Seattle Angina Questionnaire (SAQ) and Short-Form Health Survey (SF-12) domain scores were similar at 6 and 12 months between the 2,012 patients in CR and the 2,894 who did not participate.
  • Conversely, hazard ratio of all-cause mortality associated with participating in CR was 0.59.

Citation:

Kureshi F, Kennedy KF, Jones PG, et al. Association between cardiac rehabilitation participation and health status outcomes after acute myocardial infarction. [Published online ahead of print October 19, 2016]. JAMA Cardiol. doi:10.1001/jamacardio.2016.3458.

Commentary:

This large study supports the results of other studies and meta-analyses that show that cardiac rehabilitation post-MI has a strong evidence base showing improved survival.1 It is surprising that cardiac rehab did not also have a beneficial effect on quality of life, symptoms and functional status. While it is helpful to know this when advising patients so that their expectations are aligned with reality, the significant survival benefit that accrues with cardiac rehab drives the decision to recommend cardiac rehab routinely post-MI and has made it part of official American Heart Association guidelines.2 —Neil Skolnik, MD

  1. Lawler PR, Filion KB, Eisenberg MJ. Efficacy of exercise-based cardiac rehabilitation post–myocardial infarction: A systematic review and meta-analysis of randomized controlled trials. Am Heart J. 2011;162(4):571-584.e2.
  2. Krumholz HM, Anderson JL, Bachelder BL, et al. ACC/AHA 2008 performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing committee to develop performance measures for ST-elevation and non-ST-elevation myocardial infarction). Circulation. 2008;118(24):2596-2648. doi:10.1161/CIRCULATIONAHA.108.191099.

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