Long-term reduction of cardiac mortality after myocardial infarction: 10-year results of a comprehensive rehabilitation programme

The long-term outcome of different methods of post-MI care hasbeen studied in two non-selected groups of MI patients: an interventiongroup (n = 147), participating in a cardiac rehabilitation (CR)programme, was compared to a reference group receiving standardcare (n = 158). The CR programme included a post-MI clinic,physical training, information on smoking and diet, and psychologicalsupport. After 5 years there was no difference in mortality (29.3 vs31.6%), but the recurrence rate of non-fatal MI (17.3 vs 33.3%P <0.05) and of total cardiac events (39.5 vs 53.2%, P <0.05) was lower in the intervention group, and more patientswere still at work (51.8 vs 27.4% P < 0.01). After 10 years there was a reduction in total (42.2 vs 57.6%P < 0.001) and cardiac mortality (36.7 vs 48.1% P < 0.001).Fewer patients in the intervention group suffered from non-fatalreinfarction (28.6 vs 39.9%, P < 0.001). Among those patientswho had not yet reached the age of retirement more patientshad resumed employment (58.6 vs 22.0% P < 0.05). We conclude, that the secondary preventive effect of the programmehas contributed to the higher rate of survival.