While cardiac rehabilitation (rehab) has extremely low referral and attendance rates for patients with type 2 myocardial infarction (MI), these patients may greatly benefit from a comprehensive and multifaceted cardiac rehab program, according to a study published March 4 in the Journal of the American College of Cardiology which will be presented during ACC.19 in New Orleans, LA.

Cian McCarthy, MB, BCh, BAO, et al., identified 359 patients hospitalized with type 2 MI at Massachusetts General Hospital between October 2017 and May 2018. Results showed that of the 321 patients discharged, only 21 (6.5 percent) were referred to cardiac rehab. Of the 21 patients, researchers found that none attended cardiac rehab, resulting in no difference in baseline characteristics, diagnostic testing or treatment strategies among patients who were or were not referred.

The researchers note that the most remarkable finding is that patients with type 2 MI are rarely referred to cardiac rehab and even more rarely attend. They add that this practice pattern may be related to the current lack of evidence supporting cardiac rehab in patients with type 2 MI and lack of uniform insurance coverage.

McCarthy et al., explain that cardiac rehab may benefit type 2 MI patients in multiple ways including exercise; lifestyle and medication adjustment opportunities to address co-existing cardiovascular comorbidities; smoking cessation counseling; improved prescription and adherence to cardioprotective medications; and an opportunity to more closely monitor these patients who have high rates of mortality and readmission.

"Despite [this] concerning prognosis, there are currently no guideline-based recommendations or evidence-based treatments for patients with type 2 MI," the authors write. "The value of cardiac rehab for patients with type 2 MI requires evaluation in a prospective randomized clinical trial."

Clinical Topics: Cardiovascular Care Team

Keywords: ACC19, ACC Annual Scientific Session, Cardiac Rehabilitation, Smoking Cessation, Hospitals, General, Patient Readmission, Prospective Studies, Prognosis, Patient Discharge, Comorbidity, Referral and Consultation, Insurance Coverage, Myocardial Infarction, Diabetes Mellitus, Type 2

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