+

The effect of referral for cardiac rehabilitation on survival following acute myocardial infarction: a comparison survival in two cohorts collected in 1995 and 2003

Lewinter, C. and Bland, J. M. and Crouch, S. and Doherty, Patrick and Lewin, Robert and Kober, L. and Hall, A. S. and Gale, C. P. (2014) The effect of referral for cardiac rehabilitation on survival following acute myocardial infarction: a comparison survival in two cohorts collected in 1995 and 2003. European Journal of Preventive Cardiology, 21 (2). pp. 163-171.

Full text not available from this repository.

Abstract

Background International guidelines recommend referral for cardiac rehabilitation (CR) after acute myocardial infarction (AMI). However, the impact on long-term survival after CR referral has not been adjusted by time-variance. We compared the effects of CR referral after hospitalization for AMI in two consecutive decades.

Methods and results A total of 2196 and 2055 patients were recruited in the prospective observational studies of the Evaluation of the Methods and Management of Acute Coronary Events (EMMACE) -1 and 2 in 1995 and 2003, (1995: median age 72 years, 39% women, 74% referred vs 2003: median age 71 years, 36% women, 64% referred) and followed up through September 2010. Survival functions showed CR referral to be an independent predictor for survival in 2003, but not in 1995 (hazard ratio (HR), 0.90; 95% confidence interval [CI]; 0.70 to 1.17, p = 0.44 in 1995 vs HR, 0.80; 95% CI, 0.66 to 0.96, p = 0.02 in 2003) when patients entered the model at three months after discharge and had a common exit at 90 months. Significant positive and negative predictors for CR referral were beta-blocker prescription (+), reperfusion (+) and age (−) in 1995, and reperfusion (+), revascularization (+), heart failure (HF) (+), antiplatelets (+), angiotensin-converting-enzyme inhibitor (ACE-I) (+), statins (+), diabetes (−), and the modified Global Registry of Acute Cardiac Events (GRACE) risk score (−) in 2003.

Conclusions CR referral was associated with improved survival in 2003, but not in 1995 in patients admitted with acute MI.

Item Type: Article
Status: Published
DOI: 10.1177/2047487312469124
Subjects: R Medicine > R Medicine (General)
URI: http://ray.yorksj.ac.uk/id/eprint/436

University Staff: Request a correction | RaY Editors: Update this record