[Cardiac rehabilitation after acute myocardial infarction].
At the time of evidence-based medicine, while the proofs of the benefits of cardiac rehabilitation to the coronary multiply, a large number of patients are still managed without any form of rehabilitation. In particular, younger patients with myocardial infarction treated by early reperfusion and older subjects. The objective of in-hospital or ambulatory cardiac rehabilitation is a global coverage of the patient and his/her risk factors, that the short duration of hospitalization in the acute phase does not allow. Several randomized studies, metaanalyses, and registers show a decrease from 20 to 30% of the mortality after cardiac rehabilitation. The benefits of physical training on risk factors modification are demonstrated by numerous works: improvement of lipid parameters and arterial pressure, prevention of diabetes, increased smoking cessation, loss of weight, better overall well-being; besides the management of risk factors, physical training improves exercise capacity, a recognised prognostic factor. The efficiency of cardiac rehabilitation may be comparable with that of the key treatments of coronary artery disease, such as beta-blockers or coronary angioplasty. All these proofs give to the cardiac rehabilitation in post-myocardial infarction a high-level recommendation, grade IA.
Centre de réadaptation cardiaque Léopold-Bellan-d'Ollencourt, centre hospitalier de Gonesse, Tracy Le Mont, France. mohamed.ghannem@bellan.fr
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D015906:Angioplasty, Balloon, Coronary; D005081:Exercise Therapy; D006801:Humans; D009203:Myocardial Infarction / Q000534:rehabilitation* / Q000628:therapy