[Good reasons to propose to the cardiology patient a cardiologic rehabilitation program].
According to the latest data available, in Italy a cardiac rehabilitation program is currently proposed to only 17% of patients after an acute myocardial infarction and to 76% of patients after a coronary artery bypass grafting. One possible explanation for this difference is an underestimation of the rehabilitating techniques and some doubts about its efficacy on the quality of life and on secondary prevention. Regarding secondary prevention, many research results and independent reviews are now available and they give us the opportunity to develop a sufficiently evidence-based analysis of cardiac rehabilitation program results. Great improvements in functional capacity and substantial changes in the way of life seem to have been demonstrated, with good-health oriented behaviors and improvements in the whole risk profile (less cigarette smoking, more sports activities, less stress, improvement in lipid profile). It has been well proven that with comprehensive rehabilitation programs, there is a relevant slow down in atherosclerosis progression. Rehabilitation programs also have favorable effects on the quality of life in patients with cardiac disorders, with fewer symptoms and more psychological and social well being. Three high-quality meta-analyses resulted in a significant reduction in total and cardiovascular mortality, mostly linked to sudden death and fatal reinfarction reduction, equal to the one obtained by currently recommended postinfarct treatments. Certainly, there are still difficulties to overcome before definitive conclusions can be reached, because of differences both in rehabilitation programs in the various studies and because of the results achieved in recent years through changes in the pharmacological approach to secondary prevention. The Global Secondary Prevention Strategies to Limit Event Recurrence After Myocardial Infarction (GOSPEL study) from the Italian Study Group on Cardiac Rehabilitation (GICR) has been designed to answer to some of these questions. One of its goals is to evaluate whether an intensive intervention of cardiac rehabilitation in the postinfarct patients is actually applicable and efficacious.
Dipartimento di Medicina, Riabilitazione e Recupero Funzionale, Ospedale La Colletta, Arenzano (GE). rgriffo@libero.it
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D006331:Heart Diseases / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans