title: Clinical outcomes in myocardial infarction and multivessel disease after a cardiac rehabilitation programme: Partial versus complete revascularization.
abstract: BACKGROUND
  Current guideline recommendations encourage culprit vessel only percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. However, recent studies have shown a better clinical outcome in patients who receive multivessel PCI.
  
  
  OBJECTIVE
  To measure and compare clinical outcomes between partial revascularization (PR) versus complete revascularization (CR) in patients with STEMI and multivessel disease who underwent a cardiac rehabilitation programme.
  
  
  METHODS
  We retrospectively reviewed the medical records of 282 patients with STEMI and multivessel disease who received PR or CR and were subsequently enrolled in a cardiac rehabilitation programme between July 2006 and November 2013 at La Paz University Hospital. The incidences of cardiovascular events, new PCI, hospital admissions for cardiovascular reasons and mortality were compared between the PR and CR groups.
  
  
  RESULTS
  Overall, 143 patients received PR and 139 received CR. Baseline characteristics were similar in both groups, except for mean age (59.3 vs. 56.7 years; P=0.02), diabetes mellitus prevalence (34.3% vs. 20.1%; P=0.01) and number of arteries with stenosis (2.6 vs. 2.3; P=0.001). During the mean follow-up of 48.0±25.9 months, a cardiovascular event occurred in 23 (16.1%) PR patients and 20 (14.4%) CR patients, with no statistically significant differences in the early (hazard ratio: 0.61, 95% confidence interval: 0.19-1.89) or late (hazard ratio: 1.40, 95% confidence interval: 0.62-3.14) follow-up periods. Cox regression, adjusted for age, sex, presence of diabetes mellitus and number of affected coronary vessels, showed no difference in new cardiovascular event risk.
  
  
  CONCLUSIONS
  There were no statistical differences in clinical outcomes between PR and CR among patients who received cardiac rehabilitation.
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mori Junco
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain. Electronic address: reginadalmau71@gmail.com.
authors.forename: Regina
authors.initials: R
authors.lastname: Dalmau Gonzalez-Gallarza
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Castro Conde
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: González Fernandez
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Álvarez Ortega
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Zorba
authors.initials: Z
authors.lastname: Blázquez Bermejo
authors.affiliation: Research School of Population Health, The Australian National University, Canberra, Australia.
authors.forename: Luis
authors.initials: L
authors.lastname: Furuya-Kanamori
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universidario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Moreno Gomez
authors.affiliation: Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Cuidados Agudos Cardiologícos, Servico de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: López de Sa Arreses
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016016:Proportional Hazards Models; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
keywords: Angioplastie; Angioplasty; Coronaropathie; Coronary artery disease; Infarctus du myocarde; Myocardial infarction; Prognosis; Pronostic; Rehabilitation; Réadaptation