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Effect of Cardiac Rehabilitation on Outcomes in Patients with ST-Elevation Myocardial Infarction

 Hye Young Lee  ;  Sung-Jin Hong  ;  In Hyun Jung  ;  Gwang Sil Kim  ;  Young Sup Byun  ;  Byung Ok Kim 
 Yonsei Medical Journal, Vol.60(6) : 535-541, 2019 
Journal Title
 Yonsei Medical Journal 
Issue Date
Cardiac Rehabilitation* ; Coronary Angiography ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/rehabilitation* ; Treatment Outcome
Cardiac rehabilitation ; drug eluting stent ; myocardial infarction
PURPOSE: Whether cardiac rehabilitation (CR) improves clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) has not been thoroughly evaluated. Moreover, few studies have sought to identify patients who would benefit most from CR among STEMI patients. MATERIALS AND METHODS: Consecutively, 265 STEMI patients who underwent primary PCI with implantation of DESs and follow-up angiography were examined. Seventy-six patients (30%) who received CR were assigned to the CR+ group. Another 178 patients (70%) who did not participate in CR were assigned to the CR- group. Second generation DESs were implanted in 238 (94%) patients. RESULTS: Major adverse cardiovascular events (MACEs), including death, myocardial infarction, and revascularization, were compared. The CR+ group tended to have lower MACE than the CR- group at 3 years, although the difference was not statistically significant (9.9% vs. 18.3%, hazard ratio=0.54, p=0.138). Subgroup analysis revealed a significant interaction according to CR and preprocedural thrombolysis in myocardial infarction (TIMI) flow (p value for interaction=0.011). In patients with low preprocedural TIMI flow (TIMI flow ≤1, n=161), those in the CR+ group had significantly lower MACE than those in the CR- group (p=0.005), whereas MACE was not different among patients with higher TIMI flow (TIMI flow ≥2, n=93). CONCLUSION: CR including exercise training was associated with lower MACE, particularly in patients with lower preprocedural TIMI flow during primary PCI for STEMI in the current DES era.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
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