Cardiac rehabilitation improved mortality in patients after PCI

Goel K. Circulation. 2011;doi:10.1161/CIRCULATIONAHA.110.983536.

Findings from a retrospective study have suggested that patients who participated in cardiac rehabilitation within 3 months of percutaneous coronary intervention had a decreased rate of mortality. However, rates of MI and revascularization were not influenced by participation.

“Our results provide supportive evidence for the decision by Centers for Medicare and Medicaid Services to cover cardiac rehabilitation in PCI patients and for the recommendations in clinical practice guidelines and performance measures that support cardiac rehabilitation for all PCI patients,” the researchers wrote.

In the study, investigators from the Mayo Clinic in Rochester, Minn., examined consecutive patients (n=2,395) from a prospectively collected registry who underwent PCI in Olmsted County, Minnesota. During the 3 months after PCI, 964 patients (40%) participated in at least one outpatient cardiac rehabilitation session.

During a median follow-up of 6.3 years, 503 deaths (199 cardiac-related), 394 MIs and 755 revascularization procedures were reported. Patients who took part in cardiac rehabilitation had a noted reduction in all-cause mortality by all three statistical techniques employed, including propensity score-matched analysis (HR=0.54), propensity score stratification (HR=0.53) and regression adjustment with propensity score in a 3-month landmark analysis (HR=0.55; P<.001 for all three). A trend toward a reduction in cardiac-related mortality among those participated was also reported; however, only propensity score stratification documented a significant reduction (P=.016).

When researchers looked at MI and revascularization, however, no significant trends were found.

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