Return to full normal activities including work at two weeks after acute myocardial infarction.
Patients are generally advised to return to full normal activities, including work, 6 to 8 weeks after acute myocardial infarction (AMI). We assessed the outcomes of early return to normal activities, including work at 2 weeks, after AMI in patients who were stratified to be at a low risk for future cardiac events. Patients were considered for randomization before discharge if they had no angina, had left ventricular ejection fraction >40%, a negative result from a symptom-limited exercise stress test for ischemia (<2 mm ST depression) at 1 week, and achieved >7 METs. Patients with left ventricular ejection fraction <40% were included only if they did not have inducible ventricular tachycardia at electrophysiologic studies. Seventy-two patients were randomized to return to normal activities at 2 weeks and 70 patients to undergo standard cardiac rehabilitation and return to normal activities at 6 weeks after AMI. There were no deaths or heart failure in either group. There was no significant difference in the incidence of reinfarction, revascularization, left ventricular function, lipids, body mass index, smoking, or exercise test results at 6 months. In conclusion, return to full normal activities, including work at 2 weeks, after AMI appears to be safe in patients who are stratified to a low-risk group. This should have significant medical and socioeconomic implications.
Department of Cardiology, Westmead Hospital, Westmead, Sydney, Australia. kovoor@westgate.wh.usyd.edu.au
Pramesh
P
Kovoor
Astin K Y
AK
Lee
Fiona
F
Carrozzi
Virginia
V
Wiseman
Karen
K
Byth
Robert
R
Zecchin
Cheryl
C
Dickson
Madeline
M
King
Jane
J
Hall
David Leslie
DL
Ross
John Bryant
JB
Uther
Alan Robert
AR
Denniss
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014937:Work