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Mortality and Clinical Outcomes After Myocardial Infarction: The Impact of Cardiac Rehabilitation in Routine Care
Session:
Sessão de Posters 36 - Reabilitação para todos: equidade, inovação e impacto a longo prazo
Speaker:
Leonor Moura
Congress:
CPC 2026
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Maria Leonor Moura; Francisca Rafaela Nunes; Francisco Lemos de Sousa; Inês Arrobas Rodrigues; António Gonçalves; Marta Catarina Almeida; André Lobo; Marta Leite; Inês Neves; Eduardo Vilela; Rita Faria; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background: </strong>Myocardial infarction (MI) remains highly prevalent across cardiology departments. Routine care after MI includes cardiac rehabilitation (CR), whose impact on fitness, risk profile, and quality of life has been increasingly recognized over recent years.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>The aim of this study is to examine the medium-term impact of CR after MI on symptoms, cardiovascular (CV) hospital admissions and mortality.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>This retrospective study enrolled consecutive MI admissions from 2021 to 2022 in a Portuguese cardiology department. Demographic data, clinical comorbidities and MI information were collected. Three outcomes were analysed in 2025: presence of symptoms (defined as NYHA class ≥2), cardiovascular-related in patient admissions and mortality. Group comparisons (CR vs non CR) were made using Chi-square or Fisher’s exact tests. A secondary age-adjusted analysis was made using logistic regression. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results: </strong>337 patients post-MI were initially included. 27 (8%) patients were not referred to cardiac rehabilitation due to physical limitation and were excluded from analysis to decrease bias. 310 were referred to CR programme, 77% (237) were males and the mean age was 67 ±13 years. 11% (40) missed the first appointment. Of those who were referred and attended the first consultation, 123 patients did a complete CR program (37%). CR programme complete attendance was associated with a significantly lower symptomatic burden (16% vs 33%, p=0.001). Although CV admissions were not prevalent in this sample (8%), there was also a significant decrease in those who went to CR (3% vs 12%, p=0.008). Mortality occurred in 26 patients, less frequently in those in CR programme (3% vs 10%, p=0.02). When adjusted to age (considered the most important confounder), CR attendance was still significantly associated with a protective effect on symptoms (OR=0.44; 95% CI 0.24-0.81; p=0.008) and CV admissions (OR=0.31; 95% CI 0.10-0.95; p=0.04). While mortality still showed a tendency to be more prevalent in those who had not participated in CR, when adjusted for age, there was not a statistically significant difference between groups (p=0.163).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong>In this study, there was evidence of persistent benefit in CR after MI, with lower symptom burden and hospital admissions. CR also showed a trend to lower mortality, but not independently of age. Systematic referral of these patients should be routinely considered and prioritized to enhance CV outcomes.</span></span></p>
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