Long-term reduction of cardiac mortality after myocardial infarction: 10-year results of a comprehensive rehabilitation programme.
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.
Hedbäck
B
B
Department of Internal Medicine, Oskarshamn District Hospital, Sweden.
Perk
J
J
Wodlin
P
P
D002423:Cause of Death; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000534:rehabilitation*; D010353:Patient Education as Topic; D012008:Recurrence; D012050:Rehabilitation, Vocational; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D015996:Survival Rate