Subject(s)
Cardiac Surgical Procedures , Coronary Disease/therapy , Myocardial Revascularization , Aged , Angina Pectoris/diagnosis , Angina Pectoris/surgery , Angina Pectoris/therapy , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/methods , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/methods , Coronary Angiography , Coronary Disease/diagnosis , Coronary Disease/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/surgery , Myocardial Infarction/therapy , Myocardial Revascularization/adverse effects , Myocardial Revascularization/methods , Postoperative Complications/diagnosis , Prognosis , Prospective Studies , RecurrenceABSTRACT
The long-term outcome of different methods of post-MI care has been studied in two non-selected groups of MI patients: an intervention group (n = 147), participating in a cardiac rehabilitation (CR) programme, was compared to a reference group receiving standard care (n = 158). The CR programme included a post-MI clinic, physical training, information on smoking and diet, and psychological support. After 5 years there was no difference in mortality (29.3 vs 31.6%), but the recurrence rate of non-fatal MI (17.3 vs 33.3%, P < 0.05) and of total cardiac events (39.5 vs 53.2%, P < 0.05) was lower in the intervention group, and more patients were still at work (51.8 vs 27.4% P < 0.01). After 10 years there was a reduction in total (42.2 vs 57.6% P < 0.01) and cardiac mortality (36.7 vs 48.1% P < 0.001). Fewer patients in the intervention group suffered from non-fatal reinfarction (28.6 vs 39.9%, P < 0.001). Among those patients who had not yet reached the age of retirement more patients had resumed employment (58.6 vs 22.0% P < 0.05). We conclude, that the secondary preventive effect of the programme has contributed to the higher rate of survival.
