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

Background 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. Methods 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. Results 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 nonattenders. Conclusions In an unselected registry cohort of patients post myocardial infarction, compared to nonattenders those attending exercise-based cardiac rehabilitation achieved significantly larger ...