Survival Benefits of Outpatient Cardiac Rehabilitation after Acute Myocardial Infarction: Propensity Analysis Using Japanese Administrative Database
-
- Seki Tomotsugu
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University
-
- Takeuchi Masato
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University
-
- Kawasoe Shin
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Takeuchi Kazufumi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University
-
- Miki Ryusuke
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University Health Policy Department, Health Division, Health and Welfare Bureau
-
- Ueshima Kenji
- Center for Accessing Early Promising Treatment, Kyoto University Hospital
-
- Kawakami Koji
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University
この論文をさがす
抄録
<p>BACKGROUND</p><p>Survival benefit of outpatient cardiac rehabilitation (CR) after acute myocardial infarction (AMI) has recently been contested under the current real-world clinical practice. We investigated whether outpatient CR was associated with lower mortality and morbidity risks among Japanese AMI patients.</p><p>METHODS</p><p>We analyzed patients who were admitted for AMI and received both percutaneous coronary intervention and inpatient CR from January 2011 to December 2014, using a nationwide administrative database in Japan (final date of follow-up: July 31, 2016). We compared patients who received outpatient CR and who did not, and the primary outcome was a composite of all-cause death and recurrence of AMI after the landmark time-point of day 180 after discharge. We applied Cox proportional hazards model to estimate outcomes, and propensity-score matching was applied to adjust for baseline imbalances.</p><p>RESULTS</p><p>A total of 5,654 patients (mean [SD] age, 66.8 [12.4] years; 21.2% female; median follow-up period [IQR] 1.44 [0.87, 2.27] years), 730 (12.9%) participated in outpatient CR at least once within 180 days of discharge. Of 1,458 propensity-score matched patients, outpatient CR participation was associated with lower but statistically non-significant risks among the primary outcome (1.38 vs. 2.12 per 100 patient-years; HR = 0.71; 95%CI, 0.32 to 1.61).</p><p>CONCLUSIONS</p><p>Among Japanese patients who admitted for AMI and received both percutaneous coronary intervention and inpatient CR, outpatient CR was underutilized, and associated with a statistically non-significant mortality and morbidity benefits. Further study is necessary to reaffirm the real-world effectiveness of outpatient CR under the current real-world clinical practice.</p>
収録刊行物
-
- Annals of Clinical Epidemiology
-
Annals of Clinical Epidemiology 3 (1), 10-26, 2021
一般社団法人 日本臨床疫学会
- Tweet
詳細情報 詳細情報について
-
- CRID
- 1390286981374270976
-
- NII論文ID
- 130007966350
-
- ISSN
- 24344338
-
- 本文言語コード
- en
-
- データソース種別
-
- JaLC
- Crossref
- CiNii Articles
- KAKEN
-
- 抄録ライセンスフラグ
- 使用不可