title: Efficacy of out-patient cardiac rehabilitation in low prognostic risk patients after acute myocardial infarction in primary intervention era.
abstract: BACKGROUND
  The efficacy of out-patient cardiac rehabilitation (OPCR) in patients with a low prognostic risk after acute myocardial infarction (AMI) is unclear in the recent primary intervention era.
  
  
  RESULTS
  A total of 637 AMI patients who participated in in-hospital cardiac rehabilitation were divided into 2 groups; low prognostic risk group (n=219; age <65 years, successful reperfusion, Killip class I, peak serum creatine kinase <6,000U/L, and left ventricular ejection fraction ≥40%) and non-low prognostic risk group (n=418). The prevalence of coronary risk factors (CRF) was compared between the 2 groups. Then, in the low-risk group, the efficacy of OPCR was compared between active OPCR participants (n=52; ≥20 sessions/3 months) and non-active participants (n=60; <6 sessions/3 months). Compared with the non-low prognostic risk group, the low prognostic risk group had a significantly higher prevalence of current smokers (72% vs. 49%, P<0.05) and patients with multiple CRF (3 or more; 49% vs. 39%, P<0.05). Among the low- risk group, active OPCR participants showed a significantly greater improvement in exercise capacity (peak VO(2), P<0.05) and maintained a better CRF profile (total cholesterol, triglyceride and blood pressure, all P<0.05) than inactive participants at 3 months.
  
  
  CONCLUSIONS
  Low prognostic risk AMI patients have a higher prevalence of multiple CRF than non-low risk patients. Even in this low risk group, active participation in OPCR is associated with improved exercise capacity and better CRF profile.
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Research Center, Suita, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kamakura
authors.forename: Rika
authors.initials: R
authors.lastname: Kawakami
authors.forename: Michio
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Muneaki
authors.initials: M
authors.lastname: Ibuki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yanase
authors.forename: Naohiko
authors.initials: N
authors.lastname: Aihara
authors.forename: Teruo
authors.initials: T
authors.lastname: Noguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nonogi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Goto
mesh_terms: D000553:Ambulatory Care; D015415:Biomarkers; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015897:Comorbidity; D003402:Creatine Kinase / Q000097:blood; D050171:Dyslipidemias / Q000453:epidemiology; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009765:Obesity / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D020097:Natriuretic Peptide, Brain; D003402:Creatine Kinase