Impact of cardiac rehabilitation on cardiovascular event in Korea

In Sun Song1, Yu Shin Park2,3, Suk-Yong Jang3,4

  • 1Department of Health Policy, Graduate School of Public Health, Yonsei University, Seoul, South Korea.

Scientific Reports
|November 6, 2023
PubMed

Insights

Cardiac rehabilitation (CR) participation after percutaneous coronary intervention (PCI) significantly reduces myocardial infarction (MI) risk. CR did not impact stroke incidence but lowered MI risk in patients with multiple stenoses or stents.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Public Health

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for acute coronary syndrome (ACS).
  • Cardiac rehabilitation (CR) is recommended post-PCI, but its impact on major adverse cardiac events (MACE) requires further evaluation.
  • Optimizing CR participation is crucial for improving patient outcomes after PCI.

Purpose of the Study:

  • To evaluate the effect of CR participation within 30 days post-discharge on MACE in ACS patients undergoing PCI.
  • To assess the association between CR and the incidence of myocardial infarction (MI) and stroke within one year.
  • To identify subgroups of patients who benefit most from CR after PCI.

Main Methods:

  • Retrospective cohort study using electronic medical records (EMR) from a tertiary hospital in Seoul, Korea (January 2014 - February 2020).
  • Included 2988 patients with first ACS undergoing PCI, classified into CR participants and non-participants within 30 days of discharge.
  • Cox proportional hazards models were used to analyze the association between CR and MACE (MI, stroke) within one year.

Main Results:

  • CR participation was associated with a significantly lower risk of MI (HR 0.68, CI 0.53-0.86).
  • No significant association was found between CR and stroke incidence.
  • Subgroup analysis showed reduced MI risk in CR users with 3+ stenotic vessels (HR 0.55, CI 0.35-0.86) and those receiving 2+ stents (HR 0.54, CI 0.35-0.85).

Conclusions:

  • Early CR participation (within 30 days) after PCI for ACS reduces the risk of MI.
  • CR demonstrates particular benefit for patients with complex coronary artery disease (multiple stenoses or stents).
  • Findings support the expansion and enhancement of CR programs to improve outcomes for post-PCI patients.

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