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. 2025 Apr 26;14(9):3007.
doi: 10.3390/jcm14093007.

Comparison of Inpatient and Outpatient Cardiac Rehabilitation Following Myocardial Infarction

Piotr Jankowski  1   2 , Roman Topór-Mądry  3 , Paweł Kozieł  1 , Daniel Cieśla  4 , Urszula Cegłowska  2 , Monika Burzyńska  1   5 , Zbigniew Eysymontt  6 , Radosław Sierpiński  7 , Jarosław Pinkas  8 , Mariusz Gąsior  4
Affiliations

Comparison of Inpatient and Outpatient Cardiac Rehabilitation Following Myocardial Infarction

Piotr Jankowski et al. J Clin Med. .

Abstract

Background: Models of second-phase cardiac rehabilitation (CR) following myocardial infarction (MI) differ across countries. The aim of this study was to compare outcomes in MI survivors participating in outpatient and inpatient CR programs. Methods: All patients hospitalized for acute MI in Poland between October 2017 and December 2018 (n = 96,634) were included in the study. Among them, 4411 patients were referred to and commenced outpatient CR, whereas 11,626 patients started inpatient CR within 30 days following discharge. Results: The mean follow-up period was 332.8 ± 128.1 days. Younger age, male sex, and a history of cancer were associated with a higher probability of participating in outpatient CR, whereas diabetes, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, ST-elevation MI, and myocardial revascularization were associated with a lower likelihood of outpatient CR participation. Participation in outpatient CR was linked to a reduced risk of all-cause mortality, in both univariable (hazard ratio [95% confidence interval]: 0.37 [0.26-0.51]) and multivariable analyses (0.53 [0.38-0.74]). Outpatient CR was also associated with a lower risk of death, MI, or stroke (0.57 [0.48-0.67] in univariable analysis and 0.72 [0.61-0.84] in multivariable analysis), as well as a lower risk of death or cardiovascular hospitalization (0.78 [0.73-0.84] and 0.85 [0.80-0.91], respectively). Conclusions: Outpatient CR following MI tends to occur alongside a better prognosis compared to inpatient programs.

Keywords: cardiac rehabilitation; coronary artery disease; myocardial infarction; secondary prevention.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Standardized differences before and after propensity score matching, comparing covariate values for patients participating in inpatient and outpatient cardiac rehabilitation.
Figure 2
Figure 2
Kaplan–Meier curves displaying the estimated event-free survival probability of patients participating in the outpatient and inpatient cardiac rehabilitation programs following myocardial infarction. Matched groups. Panel (A): all-cause death. Panel (B): all-cause death, myocardial infarction, or stroke. (C): all-cause death or hospitalization for cardiovascular purposes.
Figure 2
Figure 2
Kaplan–Meier curves displaying the estimated event-free survival probability of patients participating in the outpatient and inpatient cardiac rehabilitation programs following myocardial infarction. Matched groups. Panel (A): all-cause death. Panel (B): all-cause death, myocardial infarction, or stroke. (C): all-cause death or hospitalization for cardiovascular purposes.
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