title: Short-term comprehensive cardiac rehabilitation after AMI is associated with reduced 1-year mortality: results from the OMEGA study.
abstract: BACKGROUND
  The prognostic effect of early, comprehensive short-term cardiac rehabilitation on top of current, guideline-adjusted treatment of acute myocardial infarction has not sufficiently been evaluated.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Within the OMEGA study population, the clinical course of 3560 patients still alive 3 months after acute myocardial infarction were evaluated by comparing patients who had attended to cardiac rehabilitation (70.6%) with those who did not. Total mortality and major adverse cerebrovascular and cardiovascular events, as well as non-fatal events, were evaluated within the time period of 4-12 months after hospital admission for acute myocardial infarction. The effect of cardiac rehabilitation on clinical events was estimated by using the propensity score method to adjust for confounding parameters in multivariate analysis.
  
  
  RESULTS
  Patients participating in cardiac rehabilitation were younger, more often had acute revascularization, less often experienced non-ST-elevation myocardial infarction, and less often had a history of diabetes or cardiovascular events. Total mortality (OR 0.46, 95% CI 0.27-0.77) and major adverse cerebrovascular and cardiovascular events (OR 0.53, 95% CI 0.38-0.75) were significantly lower in the rehabilitation group. Subgroup analysis including major clinical characteristics also revealed significantly reduced rates of total death and major adverse cerebrovascular and cardiovascular events in the rehabilitation group.
  
  
  CONCLUSIONS
  Attendance to early, comprehensive short-term cardiac rehabilitation programmes on top of current guideline-adjusted treatment of acute myocardial infarction is associated with a significantly improved 1-year prognosis.
authors.affiliation: Zentrum für Ambulante Rehabilitation am Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany rauch@zar-kardio-ludwigshafen.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Rauch
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Riemer
authors.affiliation: Curschmann Klinik, Timmendorfer Strand, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schwaab
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Diller
authors.affiliation: Herzzentrum Bad Krozingen, Bad Krozingen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Gohlke
authors.affiliation: Klinikum Friedrichshafen, Friedrichshafen, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schiele
authors.affiliation: Klinikum der Universität Heidelberg, Heidelberg, Germany.
authors.forename: Hugo
authors.initials: H
authors.lastname: Katus
authors.affiliation: Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Anselm
authors.initials: A
authors.lastname: Gitt
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
mesh_terms: D000368:Aged; D003191:Comprehensive Health Care / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000534:rehabilitation*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Acute myocardial infarction; mortality; prevention; prognosis; rehabilitation