| アブストラクト | AIMS: Cardiac rehabilitation (CR) has been shown to improve the prognosis of patients with acute myocardial infarction (AMI). In Japan, the duration of hospitalization has shortened, resulting in a lower participation rate in CR among outpatients. Therefore, we evaluated the effects of CR, stratified into inpatient and outpatient phases, on the prognosis of patients with AMI in Japan. METHODS AND RESULTS: A multi-centre, retrospective, cohort study in which extracted 4411 AMI patients from 72 institutes throughout Japan who were identified from a Japanese Registry Of All cardiac and vascular Diseases (JROAD) in 2014 was performed. The JROAD is a database from Diagnosis Procedure Combination, and we additionally investigated the detailed information about severity, complications, treatment of AMI, the results of examinations, and the 5-year prognosis with respect to CR (JROAD-CR). The patients were divided into four groups, depending on their history of CR as inpatients and outpatients. The percentages of inpatients and outpatients who received CR were 66.1% (n = 2917) and 9.91% (n = 437), respectively. The groups in which only inpatients received CR [In(+)Out(-)] and in which both inpatients and outpatients received CR [In(+)Out(+)] showed significant reductions in composite major adverse cardiovascular events [In(+)Out(-) group; hazard ratio (HR): 0.751, 95% confidence interval (CI) (0.584-0.967) and In(+)Out(+) group; HR: 0.641, 95% CI (0.426-0.964)] and all-cause mortality [In(+)Out(-) group; HR: 0.720, 95% CI (0.546-0.950) and In(+)Out(+) group; HR: 0.575, 95% CI (0.338-0.977)]. CONCLUSION: This JROAD-CR study revealed that even short periods of CR during hospitalization are important and continuing CR into the outpatient phase may further improve the prognosis of patients with AMI. |
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| 投稿者 | Suematsu, Yasunori; Minei, Akira; Sumita, Yoko; Kanaoka, Koshiro; Nakai, Michikazu; Miyamoto, Yoshihiro; Arima, Hisatomi; Nakamura, Koshi; Takura, Tomoyuki; Shimada, Kazunori; Shiraishi, Hirokazu; Fukuma, Nagaharu; Sata, Masataka; Izawa, Hideo; Fukumoto, Yoshihiro; Makita, Shigeru; Ohya, Yusuke; Miura, Shin-Ichiro |
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| 組織名 | Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan.;Department of Rehabilitation, University of the Ryukyus Hospital, Okinawa, Japan.;Department of Medical and Health Information Management, National Cerebral and;Cardiovascular Center, Osaka, Japan.;Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki,;Japan.;Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka,;Department of Public Health and Epidemiology, Graduate School of Medicine,;University of the Ryukyus, Okinawa, Japan.;Department of Healthcare Economics and Health Policy, Graduate School of;Medicine, The University of Tokyo, Tokyo, Japan.;Department of Health Care Services Management, Nihon University School of;Medicine, Tokyo, Japan.;Senkawadori Clinic, Tokyo, Japan.;Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine,;Kyoto, Japan.;Faculty of Rehabilitation and Care, Seijoh University, Aichi, Japan.;Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima,;Department of Cardiology, Fujita Health University School of Medicine, Aichi,;Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume;University School of Medicine, Fukuoka, Japan.;Department of Rehabilitation Medicine, Kawaguchi Cupola Rehabilitation Hospital,;Saitama, Japan.;Department of Rehabilitation Medicine, Saitama International Medical Center,;Saitama Medical University, Saitama, Japan.;Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School;of Medicine, University of the Ryukyus, 1 Sembaru, Nishihara-cho, Nakagami-gun,;Okinawa 903-0213, Japan.;Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma,;Jonan-ku, Fukuoka 814-0180, Japan. |
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