Exercise-based cardiac rehab beneficial for MINOCA patients

Long-term, exercise-based cardiac rehabilitation (CR) improves physical health and reduces all-cause mortality and major adverse cardiovascular events (MACEs) in patients with myocardial infarction in the absence of obstructive coronary artery disease (MINOCA), a recent study has found.

Researchers conducted a prospective cohort study on 524 MINOCA patients who underwent either an active CR intervention programme (n=262) or were designated as controls (n=262). The CR group followed a home-based training regimen consisting of moderate continuous training on a bicycle or treadmill, performed three times per week, over three years.

The CR and control groups were comparable in terms of baseline demographics, the rate of risk factors, medications taken, electrocardiography and echocardiography findings, angiographic data, and laboratory parameters.

A total of 480 patients remained enrolled after the 3-year study period and were available for assessment. The Short Form-36 questionnaire (SF-36), accomplished a year after discharge, showed that the CR group had superior physical functioning, general health, and vitality than the controls (p<0.01 for all). These contributed to a higher overall mean physical health score. Mental health, on the other hand, was comparable between arms.

In addition, maximal heart rate and peak oxygen uptake was significantly higher in patients who received the CR intervention.

Over the duration of the study, 60 patients died and 136 experienced MACEs. Kaplan-Meier curves showed that both events occurred significantly less frequently in the CR group. Multivariate Cox regression analysis confirmed that exercise-based CR exerted a protective effect against all-cause mortality and MACE.