Early Return to Normal Activities at Two Weeks After Acute Myocardial Infarction: Preliminary Results of a Randomized Study - ERNA

Hypothesis:

Following acute myocardial infarction (AMI), patients usually return to normal activities in 6-8 weeks. Researchers in Australia sought to assess the effect of an earlier return to normal activities, including return to work at 2 weeks in patients at low risk for future cardiac events.

Study Design

Patients Screened: 123
Mean Follow Up: 6 months

Patient Populations:

Patients were randomized pre-discharge if they had no angina or cardiac failure, a left ventricular ejection fraction (LVEF) >40%, an exercise stress test (EST) at 1 week that was negative for ischemia (<2 mm ST depression) and achieved a score of >7 METS.

Drug/Procedures Used:

Sixty patients underwent traditional cardiac rehabilitation with a return to normal activities at 6 weeks while 63 were randomized to early return. Follow-up occurred by phone, with an EST at 6 weeks and 6 months post-AMI, and with a gated heart pool scan at 6 months.

Principal Findings:

There were no deaths in either group and no significant difference in LVEF, development of left ventricular aneurysm, serum cholesterol, or incidence of angina, reinfarction, cardiac failure, or need for revascularization between the groups (p >0.1). The traditional rehabilitation group lost more weight and achieved better work loads at the 6-month EST (p <0.03).

Interpretation:

Among patients who experienced an acute myocardial infarction, a return to full normal activities at 2 weeks post-MI appears to be safe in low-risk patients. The ability of these patients to safely return to normal activities earlier could have significant socio-economic impact.

References:

AHA 1997, Clinical Trials, presented by Pramesh Kovoor, MD, Westmead Hospital, Westmead, Australia

Kovoor P, Lee AK, Carrozzi F, et al. Return to full normal activities including work at two weeks after acute myocardial infarction. Am J Cardiol. 2006 Apr 1;97(7):952-8.

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Lipid Metabolism, Nonstatins, Acute Heart Failure

Keywords: Depression, Cholesterol, Myocardial Infarction, Follow-Up Studies, Workload, Return to Work, Research Personnel, Heart Failure, Stroke Volume, Exercise Test


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