Effect of Cardiac Rehabilitation on Outcomes in Patients with ST-Elevation Myocardial Infarction
Yonsei Medical Journal
;
: 535-541, 2019.
Article
Dans Anglais
| WPRIM
| ID: wpr-762082
ABSTRACT
PURPOSE:
Whether cardiac rehabilitation (CR) improves clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) has not been thoroughly evaluated. Moreover, few studies have sought to identify patients who would benefit most from CR among STEMI patients. MATERIALS ANDMETHODS:
Consecutively, 265 STEMI patients who underwent primary PCI with implantation of DESs and follow-up angiography were examined. Seventy-six patients (30%) who received CR were assigned to the CR+ group. Another 178 patients (70%) who did not participate in CR were assigned to the CR− group. Second generation DESs were implanted in 238 (94%) patients.RESULTS:
Major adverse cardiovascular events (MACEs), including death, myocardial infarction, and revascularization, were compared. The CR+ group tended to have lower MACE than the CR− group at 3 years, although the difference was not statistically significant (9.9% vs. 18.3%, hazard ratio=0.54, p=0.138). Subgroup analysis revealed a significant interaction according to CR and preprocedural thrombolysis in myocardial infarction (TIMI) flow (p value for interaction=0.011). In patients with low preprocedural TIMI flow (TIMI flow ≤1, n=161), those in the CR+ group had significantly lower MACE than those in the CR− group (p=0.005), whereas MACE was not different among patients with higher TIMI flow (TIMI flow ≥2, n=93).CONCLUSION:
CR including exercise training was associated with lower MACE, particularly in patients with lower preprocedural TIMI flow during primary PCI for STEMI in the current DES era.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Réadaptation
/
Angiographie
/
Études de suivi
/
Endoprothèses à élution de substances
/
Intervention coronarienne percutanée
/
Infarctus du myocarde
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Yonsei Medical Journal
Année:
2019
Type:
Article
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