title: Cardiac rehabilitation and outcome in stable outpatients with recent myocardial infarction.
abstract: OBJECTIVE
  To compare the mortality rate and the rate of subsequent ischemic events (myocardial infarction [MI], ischemic stroke, or limb amputation) in patients with recent MI according to the use of cardiac rehabilitation or no rehabilitation.
  
  
  METHODS
  Longitudinal observational study.
  
  
  METHODS
  Ongoing registry of outpatients.
  
  
  METHODS
  Patients (N=1043) with recent acute MI were recruited; of these, 521 (50%) participated in cardiac rehabilitation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Subsequent ischemic events and mortality rates were registered.
  
  
  RESULTS
  Over a mean follow-up of 18 months, 50 patients (4.8%) died and 49 (4.7%) developed 52 subsequent ischemic events (MI: n=43, ischemic stroke: n=6, limb amputation: n=3). Both the mortality rate (.16 vs 5.57 deaths per 100 patient-years; rate ratio=.03; 95% confidence interval [CI], 0.0-0.1]) and the rate of subsequent ischemic events (1.65 vs 4.54 events per 100 patient-years; rate ratio=0.4; 95% CI, 0.2-0.7) were significantly lower in cardiac rehabilitation participants than in nonparticipants. Multivariate analysis confirmed that patients in cardiac rehabilitation had a significantly lower risk of death (hazard ratio=.08; 95% CI, .01-.63; P=.016) and a nonsignificant lower risk of subsequent ischemic events (hazard ratio=.65; 95% CI, .30-1.42).
  
  
  CONCLUSIONS
  The use of cardiac rehabilitation in patients with recent MI was independently associated with a significant decrease in the mortality rate and a nonsignificant decrease in the rate of subsequent ischemic events.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Barcelona, Spain. Electronic address: coll.roser@gmail.com.
authors.forename: Roser
authors.initials: R
authors.lastname: Coll-Fernández
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Coll
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pascual
authors.affiliation: Department of Internal Medicine, Hospital San Pedro de Alcántara, Cáceres, Spain.
authors.forename: J Francisco
authors.initials: JF
authors.lastname: Sánchez Muñoz-Torrero
authors.affiliation: Department of Internal Medicine, Hospital Municipal de Badalona, Badalona, Barcelona, Spain.
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Sahuquillo
authors.affiliation: Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Manzano
authors.affiliation: Department of Internal Medicine, Hospital de Alcañiz, Alcañiz, Teruel, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Aguilar
authors.affiliation: Department of Internal Medicine, Hospital Comarcal Valle de los Pedroches, Pozoblanco, Córdoba, Spain.
authors.forename: José N
authors.initials: JN
authors.lastname: Alcala-Pedrajas
authors.affiliation: Department of Vascular Surgery, Consorci Sanitari de Terrassa-Hospital de Terrassa, Terrassa, Barcelona, Spain.
authors.forename: Lorenzo Ramón
authors.initials: LR
authors.lastname: Alvarez
authors.affiliation: Primary Healthcare, Àrea Bàsica de Salut Gaudi, Barcelona, Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: García-Díaz
authors.affiliation: Department of Internal Medicine, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain.
authors.forename: Abel
authors.initials: A
authors.lastname: Mujal
authors.affiliation: Department of Angiology and Vascular Surgery, Hospital de Terrassa, Terrassa, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Yeste
authors.affiliation: Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000534:rehabilitation*; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome
keywords: CI; FRENA; MI; Risk Factors and Arterial Disease; confidence interval; myocardial infarction