Document Detail

An early cardiac access clinic significantly improves cardiac rehabilitation participation and completion rates in low-risk ST-elevation myocardial infarction patients.
MedLine Citation:
PMID:  21477969     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Survivors of an acute ST-elevation myocardial infarction (STEMI) remain at high risk for future cardiac events. Cardiac rehabilitation (CR) participation significantly reduces coronary artery disease (CAD) morbidity and mortality risk. Regrettably, poor utilization of CR services post STEMI is common, accentuating a critical action gap in the trajectory of CAD management. The objective of this study was to determine whether integration of an early cardiac access clinic (ECAC), held within 4-14 days of hospital discharge, could improve CR utilization rates following an STEMI.
METHODS: Between January 2008 and July 2009, 245 consecutively admitted STEMI patients (19.6% female) deemed low risk following early re-establishment of coronary blood flow, were assigned to the ECAC model. An historic comparison group (n=224) was identified based on all STEMI patient admissions at the same tertiary care facility during the 2007 calendar year that met ECAC eligibility criteria. The primary outcomes were rates of CR referral, orientation attendance, program participation, and completion.
RESULTS: The ECAC cohort had significantly higher rates of CR referral (100% vs 55.8%, P < 0.0001), orientation attendance (96.3 vs 37.1%, P < 0.0001), program participation (87.8% vs 33.5%, P < 0.0001), and completion (71.4% vs 29.9%, P < 0.001) compared to the matched historical comparison group.
CONCLUSIONS: The utilization of the ECAC model resulted in an unprecedented (∼3-fold) increase in the number of post-STEMI patients participating in CR. Given the unequivocal mortality and morbidity benefits of CR, adoption of the ECAC model has important clinical and economic relevance.
Karen Parker; James A Stone; Ross Arena; Debra Lundberg; Sandeep Aggarwal; David Goodhart; Mouhieddin Traboulsi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-07
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  27     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-03     Completed Date:  2011-12-13     Revised Date:  2012-02-28    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  619-27     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.
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MeSH Terms
Health Services Accessibility*
Middle Aged
Myocardial Infarction / diagnosis*,  rehabilitation*
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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