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riabilitazione

All the evidence provided by clinical trials conducted over the past two decades has indicated that the cardiopulmonary rehabilitation programs proposed to patients in the weeks immediately following a hospitalization for infarction acute heart attack, cardiac surgery, or an episode of heart failure help to promote physical recovery, enabling a quicker and better return to usual activities.

In addition, the training planned on an individualized basis and monitored by experienced cardiologists and rehabilitators has demonstrated favorable effects on the psychoemotional level, because it helps to overcome the trauma of the acute cardiac event and regain confidence in one’s physical potential, reducing the risk of developing depressive symptoms, decreased self-esteem, and unfounded fears of exercise in daily life.

A recent Italian study, coordinated by specialists from the Azienda Sanitaria Universitaria Integrata – University of Trieste, confirms the benefits of cardiopulmonary rehabilitation, adding important information for both patients and health systems. Based on data collected from 1280 patients (of whom 839 were enrolled in post-discharge training programs and 441 were not), cardiopulmonary rehabilitation after myocardial infarction, application of aortocoronary bypass, or percutaneous coronary revascularization is associated with a significant decrease in the risk of new hospitalizations over the next five years and long-term mortality.

In particular, the rate of new hospitalizations was more than one-third lower (from 30% to 18%) among patients who had followed the proposed individualized cardiopulmonary rehabilitation program at discharge, while all-cause mortality was even cut in half (10% vs. 19%) and mortality from cardiovascular causes literally lowered from 7% to 2%.

These outcomes are relevant for at least two reasons. First, because they were obtained in a “real-life” context, that is, by retrospectively analyzing data from patients normally treated and trained at an Italian health facility (albeit one known for excellence in the management of heart disease). Second, because they quantify the benefits offered by cardiopulmonary rehabilitation not only in terms of increased well-being and survival for patients, but also in terms of potential savings to the health care system and society resulting from fewer hospitalizations and lower mortality.

Source: Doimo S et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. European Heart Journal 2019;40:678-685. doi:10.1093/eurheartj/ehy417 (https://academic.oup.com/eurheartj/article/40/8/678/5060566)

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