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Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study.

Abstract : Background. - Clinical studies have shown a beneficial effect of cardiac rehabilitation (CR) on mortality. Objective. - To study the effect of CR prescription at discharge on 5-year mortality in patients with acute myocardial infarction (AMI). Methods. - Participants, from the 2005 French FAST-MI hospital registry, were 2894 survivors at discharge, divided according to AMI type: ST-segment elevation myocardial infarction (STEMI; n=1523) and non-STEMI (NSTEMI; n=1371). The effect of CR prescription on mortality was analysed using a Cox proportional hazards model. Results. - At discharge, 22.1% of patients had a CR prescription. Patients referred to CR were younger (62.4 vs. 67.5 years), were more frequently men and more had presented with STEMI (67.8% vs. 48.3%) than non-referred patients. Ninety-four (14.7%) deaths occurred among patients referred to CR and 585 (25.9%) among non-referred patients (P<0.001). After multivariable adjustment, the association between CR and mortality remained significant (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.60-0.96). Analyses stratified by sex, age (<60 vs. >= 60 years) and AMI type showed that the inverse association was stronger in men (HR 0.64, 95% CI 0.48-0.87) than in women (HR 0.95, 95% CI 0.64-1.39), in younger (HR 0.34, 95% CI 0.15-0.77) than in older patients (HR 0.84, 95% CI 0.65-1.07) and in NSTEMI (HR 0.63, 95% CI 0.46-0.88) than in STEMI (HR 0.99, 95% CI 0.69-1.40). Conclusion. - After hospitalization for AMI, referral to CR remains a significant predictor of improved patient survival; some subgroups seem to gain greater benefit. (C) 2015 Elsevier Masson SAS. All rights reserved.
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Contributeur : Lnc - Université de Bourgogne <>
Soumis le : jeudi 19 janvier 2017 - 18:47:56
Dernière modification le : lundi 23 novembre 2020 - 14:26:17

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Marion Pouche, Jean Ruidavets, Jean Ferrières, Marie-Christine Iliou, Hervé Douard, et al.. Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study.. Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2016, 109 (3), pp.178-87. ⟨10.1016/j.acvd.2015.09.009⟩. ⟨hal-01441551⟩



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