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ABSTRACT: Purpose
Whether cardiac rehabilitation (CR) improves clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) has not been thoroughly evaluated. Moreover, few studies have sought to identify patients who would benefit most from CR among STEMI patients.Materials and methods
Consecutively, 265 STEMI patients who underwent primary PCI with implantation of DESs and follow-up angiography were examined. Seventy-six patients (30%) who received CR were assigned to the CR+ group. Another 178 patients (70%) who did not participate in CR were assigned to the CR- group. Second generation DESs were implanted in 238 (94%) patients.Results
Major adverse cardiovascular events (MACEs), including death, myocardial infarction, and revascularization, were compared. The CR+ group tended to have lower MACE than the CR- group at 3 years, although the difference was not statistically significant (9.9% vs. 18.3%, hazard ratio=0.54, p=0.138). Subgroup analysis revealed a significant interaction according to CR and preprocedural thrombolysis in myocardial infarction (TIMI) flow (p value for interaction=0.011). In patients with low preprocedural TIMI flow (TIMI flow ?1, n=161), those in the CR+ group had significantly lower MACE than those in the CR- group (p=0.005), whereas MACE was not different among patients with higher TIMI flow (TIMI flow ?2, n=93).Conclusion
CR including exercise training was associated with lower MACE, particularly in patients with lower preprocedural TIMI flow during primary PCI for STEMI in the current DES era.
SUBMITTER: Lee HY
PROVIDER: S-EPMC6536392 | biostudies-literature | 2019 Jun
REPOSITORIES: biostudies-literature
Lee Hye Young HY Hong Sung Jin SJ Jung In Hyun IH Kim Gwang Sil GS Byun Young Sup YS Kim Byung Ok BO
Yonsei medical journal 20190601 6
<h4>Purpose</h4>Whether cardiac rehabilitation (CR) improves clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) has not been thoroughly evaluated. Moreover, few studies have sought to identify patients who would benefit most from CR among STEMI patients.<h4>Materials and methods</h4>Consecutively, 265 STEMI patients who underwent primary PCI with implantation of DESs and follow- ...[more]