Health-care consumption and recurrent myocardial infarction after 1 year of conventional treatment versus short- and long-term cardiac rehabilitation

Abstract

Background: The objective of the present study was to compare the efficacy of a conventional treatment and short- and a long-term cardiac rehabilitation program in terms of health-care consumption and recurrence of myocardial infarction in coronary heart disease (CHD) patients.

Methods: One hundred twenty-eight patients were followed over a 1-year period post-myocardial infarction (MI). The patients in the control group (n = 54) received conventional treatment (COT) including general education on CHD and risk factor management by their physician. On the other hand, 74 patients agreed to participate in a formal phase 1 and 2 short-term cardiac rehabilitation program (ST-CRP) for a period of 3 months. Of these 74 patients, 37 participated for at least 1 year post-MI in a medically supervised phase 3 long-term cardiac rehabilitation program (LT-CRP).

Results: Baseline characteristics, prevalence of CHD risk factors, and short-term cardiovascular disease (CVD) prognosis were similar among groups. After a 1-year follow-up post-MI, the percentage of patients assessed for chest pain or suspicion of cardiac-related problems at the emergency room (ER) and the total number of visits to the ER were similar among groups. However, the percentage of patients and the total number of hospital readmissions were significantly less (P < 0.05) at 1-year follow-up in the LT-CRP group. The total number and the mean of visits to the ER and hospital readmissions at 3 months were similar among the three groups. However, there were significantly fewer (P < 0.05) visits to the ER and hospital readmissions for the remainder of the year (between 3 and 12 months) for the patients in the LT-CRP group. Furthermore, patients who received COT had a significantly higher incidence of recurrent MI and fatal MI over the 1-year follow-up in comparison to the patients in the ST- and LT-CRP groups.

Conclusion: These results support the recommendation of an ST- or LT-CRP in secondary prevention to lower the incidence of recurrent and fatal MI. However, LT-CRP was more efficient at reducing health-care consumption after a 1-year follow-up post-MI than ST-CRP.