Association between cardiac rehabilitation and LDL-levels, adherence to guideline-recommended medication and mortality rate after myocardial infarction

Abstract

Aim

This study aims to identify three-month and one year mortality rate, LDL level and adherence to guideline-recommended medication in patients with myocardial infarct (MI) receiving cardiac rehabilitation (CR) compared to patients who do not.

Method

In this retrospective study, patients hospitalized in North Denmark Regional Hospital in Hjoerring (capture population 200.000) with acute coronary syndrome between January 1st, 2017, to December 31st, 2021, were included. Baseline characteristics, initial treatment of revascularization and all-cause mortality were examined through the Danish National Patient Registry, the Regional Cardiac Rehabilitation Database, and medical chart review. Patients were grouped by revascularization (yes/no) during hospitalization and CR. Adjusted Cox proportional regression model was used to assess differences in mortality and LDL levels.

Results

A total of 1209 myocardial infarction (MI) survivors were included in this study. A total of 1209 myocardial infarction (MI) survivors were included. Significant LDL reductions at 6- and 12-month follow-ups were observed in patients receiving both cardiac rehabilitation (CR) and lipid-modifying therapy at baseline (p = .001), but not in those without CR. In revascularized patients, use of multiple antithrombotic agents was lower in the no CR group at three months (57.1 % vs 78.8 %, p = .002) and one year (60 % vs 78.5 %, p = .010). Three-month mortality rate was higher among patients who did not undergo CR, both in the revascularization group (19 % vs 2 %, p = 0.001) and the non-revascularization group (18 % vs 3 %, p = 0.001).

Conclusion

Patients undergoing CR were associated with lower LDL-levels, higher adherence to guideline-recommended medication and lower mortality rate at three-month follow-up.