Background Short and medium-term benefits of cardiac rehabilitation (CR) after an acute myocardial infarction (AMI) have been well studied. However, studies on long-term benefits of such programs after percutaneous coronary intervention (PCI) are scarce. Purpose The aim of our study was to evaluate the impact of cardiac rehabilitation (CR) on very long-term mortality and morbidity after PCI. Methods We conducted a retrospective cohort study of 701 patients who underwent PCI at our hospital between 2004 and 2011. Patients were classified into two cohorts based on whether or not they participated in a CR program phase II. A follow-up was performed in May 2020. We collected the events occurring during a median follow-up of 11 years. Results 701 patients were included in our study: 291 (41.5%) participated in the CR program, whereas 410 (58.4%) refused to do it. AMI was the most frequent indication for PCI (51.9%), followed by unstable angina (42.8%). The characteristics of the cohort based on participation in the CR program are shown in the table below. Patients who participated in the CR program were younger and mostly male. However, those who refused to do it had a higher cardiovascular risk due to a higher percentage of multivessel disease, diabetes mellitus, kidney failure and history of cerebrovascular accident. Using multivariate logistic regression, CR participation was found to be associated with significantly reduced all-cause mortality (19.5 vs 48.4%; OR 0.455; IC95% 0.295–0.701; p<0.001) and cardiac mortality (4.5% vs 18.0%; OR 0.361; IC95% 0.181–0.721; p 0.004). CR is also associated with a substantial decrease in heart failure hospitalization (10.0% vs 24.8%; OR 0.557; IC95% 0.331–0.937; p 0.027) and incidence of stroke (5.5% vs 10.6%; OR 0.491; IC95% 0.271–0.890; p<0.017) during the follow-up. No significant differences were observed in re-AMI (20.6% vs 24.1%, p=NS). Conclusion CR participation after PCI is associated with lower all-cause mortality, cardiac mortality, heart failure hospitalization rates and morbidity during long-term follow-up. FUNDunding Acknowledgement Type of funding sources: None.

Background Incomplete revascularization versus complete revascularization in patients undergoing percutaneous coronary intervention (PCI) is associated with higher risk of mortality and major adverse cardiac events. Cardiac rehabilitation (CR) is one of the most important evidence-based interventions for secondary prevention after ischemic heart disease. However, it has been less studied in patients with incomplete PCI. Purpose The aim of our study was to evaluate the effects of CR on long-term clinical outcomes after incomplete PCI. Methods Unicentric, descriptive and analitical study. We included 285 patients who underwent incomplete PCI at our hospital from 2004 to 2011. We compared those who participated in a CR program with those who refused to. We analyzed events occurring during a median follow-up of 11 years. Results This study included 285 patients, 121 (42.5%) participated in the CR program. Attending to baseline characteristics, there were significant differences in prevalence of male gender (88.4% vs 67.7%, p=0.000) and DM (69.4% vs 51.8%, p=0.003), which were more prevalent in CR group; they were also significantly younger (58.81 vs 66.34 years, p=0.000). Acute myocardial infarction (AMI) was the most common indication for PCI in those who attended CR, whereas in the other group it was unstable angina. Using univariate logistic analysis, CR participation was found to be associated with significantly reduced heart failure readmissions (14.2% vs 31.7%; OR 0.356; IC95% 0.193- 0.656; p=0.001), all-cause mortality (21.5% vs 56.7%; OR 0.209; IC95% 0.123- 0.356; p=0.000) and cardiovascular mortality (5.8% vs 26.8%; OR 0.167; IC95% 0.072- 0.387; p 0.000). No significant differences were observed in re-AMI (20.8% vs 26.4%, p=0.280) nor incidence of stroke (5.8% vs 9.8%, p=0.226) during the follow-up. The multivariate regression showed as well that CR was associated with a lower rate of all-cause and cardiovascular mortality and heart failure readmissions. Other predictors of clinical outcomes were NYHA stage, age >65 years and LVEF <40%. Conclusion CR is an excellent strategy for reducing hospital readmissions and mortality during long-term follow-up in patients with incomplete PCI. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Hospital Universitario de Valme, Sevilla, Spain Baseline characteristics