Association between attending exercise-based cardiac rehabilitation and cardiovascular risk factors at one-year post myocardial infarction

• Published in: PloS one Vol. 15; no. 5; p. e0232772
• Main Authors: Sjölin, Ingela, Bäck, Maria, Nilsson, Lennart, Schiopu, Alexandru, Leosdottir, Margret
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.05.2020; Public Library of Science (PLoS)
• Subjects: Aerobics; Biology and Life Sciences; Blood pressure; Cardiac patients; Cardiac rehabilitation; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cholesterol; Clinical outcomes; Clinical trials; Comorbidity; Coronary artery disease; Coronary vessels; Diseases; Evidence-based medicine; Exercise; Exercise therapy; Fasting; Fitness training programs; Health risks; Health sciences; Heart attack; Heart attacks; Heart diseases; Heart rate; Hospitalization; Hospitals; Lipids; Low density lipoproteins; Medical research; Medicine and Health Sciences; Men; Myocardial infarction; Patient outcomes; Patients; Physical fitness; Regression analysis; Rehabilitation; Retirement benefits; Risk analysis; Risk assessment; Risk factors; Setting (Literature); Smoking; Smoking cessation; Studies; Triglycerides; Variables; Womens health; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0232772

Randomized trials confirm the benefits of exercise-based cardiac rehabilitation on cardiovascular risk factors. Whether exercise-based cardiac rehabilitation provides the same favourable effects in real-life cardiac rehabilitation settings, in the modern era of myocardial infarction treatment, is less well known. We examined the association between attending exercise-based cardiac rehabilitation and improvements in cardiovascular risk factors at one-year post myocardial infarction in patients included in the Swedish heart disease registry, SWEDEHEART. In this retrospective registry-based cohort study, we included 19 136 patients post myocardial infarction (75% men, 62.8±8.7 years) who were registered in SWEDEHEART between 2011 and 2013. The association between attending exercise-based cardiac rehabilitation (43% participation rate) and changes in cardiovascular risk profile between baseline and one-year follow-up was assessed using multivariable regression analysis adjusting for age, comorbidities and medication. Attenders more often reported to have stopped smoking (men 64% vs 50%; women 64% vs 53%, p<0.001 for both, only smokers at baseline considered), be more physically active (men 3.9±2.5 vs 3.4±2.7 days/week; women 3.8±2.6 vs 3.0±2.8 days/week, p<0.001 for both) and achieved a slightly larger reduction in triglycerides (men -0.2±0.8 vs -0.1±0.9 mmol/L, p = 0.001; women -0.1±0.6 vs 0.0±0.8 mmol/L, p = 0.01) at one-year compared to non-attenders. Male attenders gained less weight (+0.0±5.7 vs +0.3±5.7 kg, p = 0.01) while female attenders achieved better lipid control (total cholesterol -1.2±1.4 vs -0.9±1.4 mmol/L, p<0.001; low-density lipoprotein -1.2±1.2 vs -0.9 ±1.2 mmol/L, p<0.001) compared to non-attenders. In an unselected registry cohort of patients post myocardial infarction, compared to non-attenders those attending exercise-based cardiac rehabilitation achieved significantly larger improvements in cardiovascular risk factors at one-year after the acute event.