Cardiac rehabilitation after myocardial infarction in the community

Brandi J. Witt, Steven J. Jacobsen, Susan A. Weston, Jill M. Killian, Ryan A. Meverden, Thomas G. Allison, Guy S. Reeder, Véronique L. Roger

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261 Scopus citations

Abstract

The aim of this study was to examine participation in cardiac rehabilitation after myocardial infarction (MI) by age and gender and the association of participation with survival. Lesser participation in cardiac rehabilitation has been reported for women and the elderly. All incident MIs in Olmsted County were validated. Baseline characteristics and outcomes were ascertained from the medical record. Logistic regression examined the association between participation, age, and gender. Propensity scores were used to examine the association between participation and outcome. Among 1,821 persons with incident MI (58% men, 46% age >70 years), 55% participated in cardiac rehabilitation. Participants were more likely to be men, younger, and have fewer comorbidities (p < 0.01 for all comparisons). After adjustment, women were 55% less likely to participate than men (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.34 to 0.60), and persons 70 years or older were 77% less likely to participate than persons younger than 60 (OR 0.23, 95% CI 0.16 to 0.33). Participants had a lower risk of death and recurrent MI at three years (p < 0.001 and p = 0.049, respectively). The survival benefit associated with participation was stronger in more recent years (relative risk [RR] for 1998 vs. 1982 0.28, 95% CI 0.18 to 0.43; RR for 1990 vs. 1982 0.41, 95% CI 0.33 to 0.52). Approximately half of the patients participated in cardiac rehabilitation after MI. Participation did not increase over time. Women and elderly persons were less likely to participate, independently of other characteristics. Participation in rehabilitation was independently associated with decreased mortality and recurrent MI, and its protective effect was stronger in more recent years.

Original languageEnglish (US)
Pages (from-to)988-996
Number of pages9
JournalJournal of the American College of Cardiology
Volume44
Issue number5
DOIs
StatePublished - Sep 1 2004

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Witt, B. J., Jacobsen, S. J., Weston, S. A., Killian, J. M., Meverden, R. A., Allison, T. G., Reeder, G. S., & Roger, V. L. (2004). Cardiac rehabilitation after myocardial infarction in the community. Journal of the American College of Cardiology, 44(5), 988-996. https://doi.org/10.1016/j.jacc.2004.05.062