Clinical research studyParticipation in Cardiac Rehabilitation, Readmissions, and Death After Acute Myocardial Infarction
Section snippets
Study Design and Setting
This study was conducted in Olmsted County, Minnesota. Population-based research is possible because there are few hospitals, namely, Olmsted Medical Center and Mayo Clinic. Medical records from all sources of care for residents are extensively indexed and linked via the Rochester Epidemiology Project.13 Therefore, patient-level information can be obtained via the medical and administrative records. This study was approved by the Mayo Clinic and Olmsted Medical Center Institutional Review
Patient Characteristics
A total of 2991 patients were diagnosed with incident myocardial infarction from January 1, 1987, to September 30, 2010, and survived to hospital discharge. The characteristics of the study population are shown in Table 1. Cardiac rehabilitation participants were more likely to be obese, to smoke, to have hyperlipidemia, to be cared for by a cardiologist in the hospital, to receive reperfusion/revascularization, to be treated with beta-blockers and aspirin, and to have ST-elevation myocardial
Discussion
Among this community cohort, only half of patients participated in cardiac rehabilitation after myocardial infarction. Although age and gender disparities existed in likelihood of participation, they narrowed over time. Participation in cardiac rehabilitation was associated with a lower post-myocardial infarction mortality and a reduced risk of cardiovascular and noncardiovascular readmissions.
Conclusions
Despite the clear benefits of participation in cardiac rehabilitation, it remains underused after acute myocardial infarction. In this community cohort, although only half of patients attended cardiac rehabilitation, participation was associated with marked reductions in hospital readmissions and mortality. Increasing participation in cardiac rehabilitation after myocardial infarction should be considered as part of a strategy to reduce readmissions.
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Cited by (0)
Funding: This study was supported by grants from the National Institutes of Health (K23 HL116643 [SMD] and RO1-HL59205 [VLR]), and was made possible by the Rochester Epidemiology Project (R01-AR30582 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases).
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.