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In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study
OBJECTIVES: To verify the associations between participation in an in-hospital cardiac rehabilitation (CR) programme and clinical outcomes among patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). DESIGN: A retrospective cohort study using the Japanese adm...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526270/ https://www.ncbi.nlm.nih.gov/pubmed/32994256 http://dx.doi.org/10.1136/bmjopen-2020-039096 |
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author | Kanazawa, Natsuko Iijima, Hiroaki Fushimi, Kiyohide |
author_facet | Kanazawa, Natsuko Iijima, Hiroaki Fushimi, Kiyohide |
author_sort | Kanazawa, Natsuko |
collection | PubMed |
description | OBJECTIVES: To verify the associations between participation in an in-hospital cardiac rehabilitation (CR) programme and clinical outcomes among patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). DESIGN: A retrospective cohort study using the Japanese administrative claims database. SETTING: Japanese acute-care hospitals. PARTICIPANTS: Patients aged ≥18 years who underwent PCI due to AMI and survived to discharge. PRIMARY AND SECONDARY OUTCOME MEASURE: The primary outcomes were revascularisation, all-cause readmission and cardiac readmission (median follow-up period: 324 days, 236 days and 263 days, respectively). The secondary outcomes were all-cause mortality and cardiac mortality (median follow-up period: both were 460 days). RESULT: The data of 13 697 patients were extracted from the database, and 65.4% of them participated in an in-hospital CR. The risks of revascularisation, all-cause readmission and cardiac readmission among CR participants were compared with those of non-participants using two statistical techniques: matched-pair analysis based on propensity score and a 30-day landmark analysis. The results of those analysis were consistent and showed that the CR participants had lower risk of revascularisation (adjusted HR: 0.74; 95% CI: 0.65 to 0.84), all-cause readmission (HR: 0.81; 95% CI: 0.74 to 0.88) and cardiac readmission (HR: 0.77; 95% CI: 0.70 to 0.85). However, all-cause mortality and cardiac mortality were not associated with participation in the CR. CONCLUSIONS: It was suggested that in-hospital CR participation may reduce the risk of revascularisation, all-cause readmission and cardiac readmission among patients with AMI after PCI. In-hospital CR may expand the potential benefits of CR in addition to outpatient CR. |
format | Online Article Text |
id | pubmed-7526270 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-75262702020-10-19 In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study Kanazawa, Natsuko Iijima, Hiroaki Fushimi, Kiyohide BMJ Open Rehabilitation Medicine OBJECTIVES: To verify the associations between participation in an in-hospital cardiac rehabilitation (CR) programme and clinical outcomes among patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). DESIGN: A retrospective cohort study using the Japanese administrative claims database. SETTING: Japanese acute-care hospitals. PARTICIPANTS: Patients aged ≥18 years who underwent PCI due to AMI and survived to discharge. PRIMARY AND SECONDARY OUTCOME MEASURE: The primary outcomes were revascularisation, all-cause readmission and cardiac readmission (median follow-up period: 324 days, 236 days and 263 days, respectively). The secondary outcomes were all-cause mortality and cardiac mortality (median follow-up period: both were 460 days). RESULT: The data of 13 697 patients were extracted from the database, and 65.4% of them participated in an in-hospital CR. The risks of revascularisation, all-cause readmission and cardiac readmission among CR participants were compared with those of non-participants using two statistical techniques: matched-pair analysis based on propensity score and a 30-day landmark analysis. The results of those analysis were consistent and showed that the CR participants had lower risk of revascularisation (adjusted HR: 0.74; 95% CI: 0.65 to 0.84), all-cause readmission (HR: 0.81; 95% CI: 0.74 to 0.88) and cardiac readmission (HR: 0.77; 95% CI: 0.70 to 0.85). However, all-cause mortality and cardiac mortality were not associated with participation in the CR. CONCLUSIONS: It was suggested that in-hospital CR participation may reduce the risk of revascularisation, all-cause readmission and cardiac readmission among patients with AMI after PCI. In-hospital CR may expand the potential benefits of CR in addition to outpatient CR. BMJ Publishing Group 2020-09-29 /pmc/articles/PMC7526270/ /pubmed/32994256 http://dx.doi.org/10.1136/bmjopen-2020-039096 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Rehabilitation Medicine Kanazawa, Natsuko Iijima, Hiroaki Fushimi, Kiyohide In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title | In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title_full | In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title_fullStr | In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title_full_unstemmed | In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title_short | In-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
title_sort | in-hospital cardiac rehabilitation and clinical outcomes in patients with acute myocardial infarction after percutaneous coronary intervention: a retrospective cohort study |
topic | Rehabilitation Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526270/ https://www.ncbi.nlm.nih.gov/pubmed/32994256 http://dx.doi.org/10.1136/bmjopen-2020-039096 |
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