Comparison of Inpatient and Outpatient Cardiac Rehabilitation Following Myocardial Infarction

Area of Science:

• Cardiology
• Public Health
• Rehabilitation Medicine

Background:

• Second-phase cardiac rehabilitation (CR) models vary globally post-myocardial infarction (MI).
• Understanding the comparative effectiveness of outpatient versus inpatient CR is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the clinical outcomes of myocardial infarction (MI) survivors undergoing outpatient CR versus inpatient CR.
• To identify factors associated with participation in different CR modalities.

Main Methods:

• A large cohort study in Poland including 96,634 acute MI patients from October 2017 to December 2018.
• Compared outcomes for 4,411 patients in outpatient CR and 11,626 patients in inpatient CR initiated within 30 days post-discharge.
• Utilized univariable and multivariable analyses to assess outcomes.

Main Results:

• Outpatient CR participation was associated with significantly reduced risks of all-cause mortality (HR 0.53) and death or major adverse cardiovascular events (death, MI, stroke) (HR 0.72).
• Outpatient CR also showed a lower risk of death or cardiovascular hospitalization (HR 0.85).
• Factors like younger age and male sex favored outpatient CR, while comorbidities such as diabetes and heart failure were linked to lower outpatient CR likelihood.

Conclusions:

• Outpatient cardiac rehabilitation following myocardial infarction is associated with a better prognosis compared to inpatient programs.
• The findings suggest that outpatient CR may be a more favorable option for MI survivors when feasible.