Impacto pronóstico de la realización de un programa de rehabilitación cardiaca tras un síndrome coronario agudo

Abstract

Aim

Reduction of major adverse cardiovascular events (MACE) at 5 years in patients with acute coronary syndrome (ACS) and percutaneous coronary intervention who completed a cardiac rehabilitation program.

Methods

We included 230 consecutive men with a diagnosis of ACS and percutaneous coronary intervention in the first half of 2015 according to the inclusion criteria. Two cohorts of 115 patients each were compared, one of them (rehabilitated group) with patients who completed the cardiac rehabilitation program and the other (control group) who received conventional outpatient care. Base-line characteristics and MACE at 5-years follow-up were compared and analyzed. MACE included re-infarction, heart failure, cerebrovascular accident and all-cause mortality.

Results

At 5 years of follow-up, a statistically significant reduction in MACE (27.19% vs 7.83%; OR 0.23 [IC 0.10-0.50]; P = .0001), all-cause mortality (OR 0.12 [IC 0.01-0.94]; P = 0.01), re-infarction rate (OR 0.29 [IC 0.11-0.77]; P = .007) and cerebrovascular accident (P = .014) was found in the rehabilitated group (RG). MACE-free survival was significantly longer in the RG, regardless of risk (HR 0.25 [IC 0.12-0.53]; P = .000).

Conclusion

In our sample, cardiac rehabilitation programs showed a prognostic benefit in patients with ACS and percutaneous coronary intervention, with a statistically significant reduction in MACE, re-infarction rate and CVA at five-year follow-up.