Referral for cardiac rehabilitation after acute myocardial infarction: Insights from nationwide AMIS Plus registry 2005–2017
| Autor: | Fabienne Witassek, Matthias Hermann, Paul Erne, Dragana Radovanovic, Hans Rickli |
|---|---|
| Přispěvatelé: | University of Zurich, Hermann, Matthias |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Referral medicine.medical_treatment Myocardial Infarction 610 Medicine & health 030204 cardiovascular system & hematology 2705 Cardiology and Cardiovascular Medicine Cohort Studies 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine medicine Humans Registries cardiovascular diseases 030212 general & internal medicine Myocardial infarction Risk factor Referral and Consultation Aged Killip class Aged 80 and over Cardiac Rehabilitation Rehabilitation business.industry 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) Middle Aged medicine.disease Conventional PCI 10209 Clinic for Cardiology Female Cardiology and Cardiovascular Medicine business Switzerland Dyslipidemia |
| Zdroj: | International Journal of Cardiology. 261:1-5 |
| ISSN: | 0167-5273 |
| Popis: | Background Referral rates for cardiac rehabilitation (CR) after an acute myocardial infarction (AMI) are low despite a Class I recommendation in the present guidelines. Therefore, we aimed to identify predictors for referral and patient characteristics from the national Swiss AMIS Plus registry. Design and methods Data were extracted from the Swiss AMIS Plus registry between 2005 and 2017, which included patients with ST-elevation myocardial infarction (STEMI) and Non-ST-elevation myocardial infarction (NSTEMI). For 32,416 patient (93.2%) data about destination at discharge were available with 10,940 (33.7%) having a recommendation for CR while 12,282 (37.9%) went home. 9194 (28.4%) were transferred to another hospital after index hospitalisation and were excluded. Results Patients referred to CR were younger (62.6 vs. 68.2 years) and had a higher prevalence of obesity (22.0% vs. 20.4%). Except for smoking (44.0% vs 34.9%), they had less risk factors such as dyslipidemia (55.0% vs. 60.1%), hypertension (55.6% vs. 65.3%) and diabetes (16.7% vs. 21.5%). Patients with in-hospital complications were more likely being referred for CR. Furthermore, STEMI (OR 1.61; CI 1.52–1.71), performed PCI (OR 2.65; CI 2.42–2.90) and Killip class >2 (OR 1.58; CI 1.36–1.84) favoured referral for CR, while age > 65 years, previous myocardial infarction, cerebrovascular disease or peripheral artery disease had a negative impact on referral for CR. Conclusions Our data from 23,222 patients after AMI demonstrate that in Switzerland patients referred for CR are younger, more obese with more STEMI. In-hospital complications were strong predictors for CR recommendation. Unlike anticipated, other risk factors were less present in CR patients. |
| Databáze: | OpenAIRE |
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