Article : Cardiac Rehabilitation After Percutaneous Coronary...

Cardiac Rehabilitation After Percutaneous Coronary Intervention Reduces Mortality

So why are fewer than half of PCI recipients being referred?



Cardiac rehabilitation improves outcomes after a wide variety of coronary events, including acute coronary syndromes (ACSs), coronary artery bypass grafting or valve surgery, and coronary stent placement. Based on the strength of these data, referral to cardiac rehabilitation is a performance measure for clinicians and centers treating ACS patients. To assess the relation between cardiac rehabilitation participation and all-cause mortality after percutaneous coronary intervention (PCI), investigators studied data on 2395 consecutive patients who underwent PCI (26% elective, 42% urgent, and 32% emergent) in Rochester, Minnesota, between January 1994 and July 2008. Forty percent of patients participated in at least one cardiac rehabilitation session within 3 months after PCI. About one third had received a drug-eluting stent.

The investigators conducted a propensity-score analysis, a matched-group analysis using propensity scores, and a landmark analysis that excluded all patients who died, had a coronary event, or underwent revascularization within 3 months after the index procedure. Compared with patients who did not participate in cardiac rehabilitation, those who did had relative reductions in all-cause mortality of 47% according to the propensity-score analysis, 46% according to the matched-group analysis, and 45% according to the landmark analysis. The results were consistent regardless of age, sex, and type of PCI.


Citation(s):

Goel K et al. Impact of cardiac rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation 2011 May 31; 123:2344.

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