title: Age does matter: Younger pPCI patients profit more from cardiac rehabilitation than older patients.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) is recommended as secondary prevention in primary percutaneous coronary intervention (pPCI) patients. This study was conducted to expand the knowledge about age-effects of CR in pPCI patients. The aim of this study was to compare changes in subjective health status (SHS) during and after CR between patients <60years and patients ≥60years, who underwent pPCI after myocardial infarction.
  
  
  METHODS
  Between 2009 and 2011, in total 282 pPCI patients who participated in CR were included. Patients completed the Short Form 12 (SF-12) questionnaire at baseline (pre-CR), 3months (post-CR) and 12months follow-up. Patients were divided into two age-groups, <60years versus ≥60years. To compare improvements in SHS between groups, Generalized Estimating Equations (GEE) analyses were performed.
  
  
  RESULTS
  The mean physical component summary (PCS) score improved over time in both groups and even reached mean levels of the normative Dutch population. The improvement on the PCS score was equal in both age groups. The mental component summary (MCS) score also improved in both groups. Patients <60years reported on average more improvement on the MCS score than patients ≥60years (Exp(B) 1.019; 95%CI 1.009-1.030; P<0.001). However, mean levels of the normative Dutch population were not reached by patients <60years.
  
  
  CONCLUSIONS
  Even though pPCI patients <60years reported more improvement on the MCS score, mean levels of the normative Dutch population were not reached. Therefore, a tailored CR program with more focus on their mental status, may be beneficial in younger patients.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Pieters
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Elisabeth M W J
authors.initials: EM
authors.lastname: Utens
authors.affiliation: Capri Cardiac Rehabilitation Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Ter Hoeve
authors.affiliation: Capri Cardiac Rehabilitation Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: Myrna
authors.initials: M
authors.lastname: van Geffen
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Karolijn
authors.initials: K
authors.lastname: Dulfer
authors.affiliation: Capri Cardiac Rehabilitation Rotterdam, The Netherlands.
authors.forename: Madoka
authors.initials: M
authors.lastname: Sunamura
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, The Netherlands. Electronic address: r.vandomburg@erasmusmc.nl.
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: D000367:Age Factors; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation* / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac rehabilitation; Myocardial infarction; Percutaneous coronary intervention; Subjective health status