Slow Gait Speed and Cardiac Rehabilitation Participation in Older Adults After Acute Myocardial Infarction

Background Lack of participation in cardiac rehabilitation (CR) and slow gait speed have both been associated with poor long‐term outcomes in older adults after acute myocardial infarction (AMI). Whether the effect of CR participation on outcomes after AMI differs by gait speed is unknown. Methods a...

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Veröffentlicht in:Journal of the American Heart Association Jg. 7; H. 5
Hauptverfasser: Flint, Kelsey, Kennedy, Kevin, Arnold, Suzanne V., Dodson, John A., Cresci, Sharon, Alexander, Karen P.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England John Wiley and Sons Inc 06.03.2018
Wiley
Schlagworte:
acute myocardial infarction
Age Factors
Aged
cardiac rehabilitation
Cardiac Rehabilitation - adverse effects
Cardiac Rehabilitation - methods
Cardiac Rehabilitation - mortality
Clinical Decision-Making
Disability Evaluation
Exercise Therapy - adverse effects
Exercise Therapy - methods
Exercise Therapy - mortality
Female
frailty
function
gait speed
Humans
Male
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - physiopathology
Myocardial Infarction - rehabilitation
Original Research
Prospective Studies
Recovery of Function
Registries
Time Factors
Treatment Outcome
United States
Walk Test
Walking Speed
United States
gait speed
frailty
acute myocardial infarction
cardiac rehabilitation
function
ISSN:2047-9980, 2047-9980
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Zusammenfassung:Background Lack of participation in cardiac rehabilitation (CR) and slow gait speed have both been associated with poor long‐term outcomes in older adults after acute myocardial infarction (AMI). Whether the effect of CR participation on outcomes after AMI differs by gait speed is unknown. Methods and Results We examined the association between gait speed and CR participation at 1 month after discharge after AMI, and death and disability at 1 year, in 329 patients aged ≥65 years enrolled in the TRIUMPH (Translational Research Investigating Underlying Disparities in Recovery From Acute Myocardial Infarction: Patients' Health Status) registry. Among these patients, 177 (53.7%) had slow gait speed (<0.8 m/s) and 109 (33.1%) participated in CR. Patients with slow gait speed were less likely to participate in CR compared with patients with normal gait speed (27.1% versus 40.1%; P=0.012). In unadjusted analysis, CR participants with normal gait speed had the lowest rate of death or disability at 1 year (9.3%), compared with those with slow gait speed and no CR participation (43.2%). After adjustment for cardiovascular risk factors and cognitive impairment, both slow gait speed (odds ratio, 2.30; 95% confidence interval, 1.30–4.06) and non‐CR participation (odds ratio, 2.34; 95 confidence interval, 1.22–4.48) were independently associated with death or disability at 1 year. The effect of CR on the primary outcome did not differ by gait speed (P=0.70). Conclusions CR participation is associated with reduced risk for death or disability after AMI. The beneficial effect of CR participation does not differ by gait speed, suggesting that slow gait speed alone should not preclude referral to CR for older adults after AMI.
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ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.117.008296