title: Cardiac rehabilitation: health characteristics and socio-economic status among those who do not attend.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) is well documented, in randomised trials, to reduce mortality risk after myocardial infarction (MI). Selection of healthy patients for CR is a relatively unexplored problem. Our aims were to identify predictors of CR-attendance and to describe the prognosis as concerns mortality, re-admission and invasive treatment among CR-attendees as compared to CR-non-attendees.
  
  
  METHODS
  From a cohort of 138 290 persons aged 30-69 years, we identified consecutive MI patients, between 1 April 2000 and 31 March 2002. There were 206 MI patients, who survived until admission, and among the 200 who survived 30 days, 145 (72.5%) attended a comprehensive CR programme. Data were obtained from patient charts and from Danish population registers, and as a result we had no non-participation for the study.
  
  
  RESULTS
  The 2-year mortality proportions for patients surviving the first 30 days of admission were 2.8 and 21.8% among CR-attendees and CR-non-attendees, respectively (P < 0.0001). Among CR-non-attendees, there was a smaller fraction having an invasive treatment performed as compared with CR-attendees. By multiple logistic regression controlling for age and sex, CR-attendance was associated with chest pain, whereas CR-non-attendance was associated with low gross income, single living and inverted T-wave in the electrocardiogram.
  
  
  CONCLUSIONS
  CR attendance rate was 72.5%. Non-attendees have a higher mortality risk, which in part may be attributed to selection of healthy patients. Non-attendees are older and more likely to have atypical symptoms at admission, a low socioeconomic status and to live alone. Special attention is needed to improve CR attendance among such patients.
authors.affiliation: Department of Internal Medicine and Cardiology, Aarhus Sygehus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, Denmark. Melgaard@dadlnet.dk
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Nielsen
authors.forename: Ole
authors.initials: O
authors.lastname: Faergeman
authors.forename: Anders
authors.initials: A
authors.lastname: Foldspang
authors.forename: Mogens L
authors.initials: ML
authors.lastname: Larsen
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation*; D010349:Patient Compliance; D012923:Social Class