1. Inicio
  2. Publicaciones
  3. Randomized Comparison of Exercise Intervention Versus Usual Care in Older Adult Patients with Frailty After Acute Myocardial Infarction.

Randomized Comparison of Exercise Intervention Versus Usual Care in Older Adult Patients with Frailty After Acute Myocardial Infarction.

Fecha de publicación: Fecha Ahead of Print:

Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Sastre, Clara
  • Ruescas, Arantxa
  • Ruiz, Vicente
  • Gonzalez, Jessika

Grupos y Plataformas de I+D+i

Abstract

BACKGROUND: Older adult patients with frailty are rarely involved in rehabilitation programs after myocardial infarction. Our aim was to investigate the benefits of exercise intervention in these patients. METHODS: A total of 150 survivors after acute myocardial infarction, =70 years and with pre-frailty or frailty (Fried scale =1 points), were randomized to control (n = 77) or intervention (n = 73) groups. The intervention consisted of a 3-month exercise program, under physiotherapist supervision, followed by an independent home-based program. The main outcome was frailty (Fried scale) at 3 months and 1 year. Secondary endpoints were clinical events (mortality or any readmission) at 1 year. RESULTS: Mean age was 80 years (range = 70-96). In the intervention group, 44 (60%) out of 73 patients participated in the program and 23 (32%) completed it. Overall, there was a decrease in the Fried score in the intervention group at 3 months, with no effect at 1 year. However, in the intention-to-treat analysis, such change did not achieve statistical significance (P = 0.110). Only treatment comparisons made among the subgroups that participated in (P = 0.033) and completed (P = 0.018) the program achieved statistical significance. There were no differences in clinical events. Worse Fried score trajectory along follow-up increased mortality risk (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.24-4.55, P = 0.009) CONCLUSIONS: Recruitment and retention for a physical program in older adult patients with frailty after myocardial infarction was challenging. Frailty status improved in the subgroup that participated in the program, although this benefit was attenuated after shifting to a home-based program. A better frailty trajectory might influence midterm prognosis. (ClinicalTrials.govNCT02715453).

Copyright © 2020 Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
1555-7162, 0002-9343

AMERICAN JOURNAL OF MEDICINE  Elsevier Inc.

Tipo:
Article
Páginas:
383-390
PubMed:
33228950

Citas Recibidas en Web of Science: 20

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Keywords

  • Acute myocardial infarction; Frailty; Rehabilitation

Campos de Estudio

Financiación

INSTITUTO SALUD CARLOS III (CB16/11/00420)
INSTITUTO SALUD CARLOS III (PI15/00837)

Proyectos y Estudios Clínicos

Comparación aleatoria entre un estrategia de intervención sobre fragilidad frente a la estrategia habitual en pacientes frágiles después de un infarto agudo de miocardio.

Investigador Principal: JUAN SANCHIS FORES

PI15/00837 . INSTITUTO SALUD CARLOS III . 2016

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

Cita

Compartir