Cardiac rehabilitation and survival in a large representative community cohort of Dutch patients
H De Vries et al
Eur Heart J 2015:36:1519-28
The authors of this publication studied a very large and representative part of the population of the Netherlands (22%, more than 3 million people), based on the billing database of a health insurance company. They studied all patients with an acute coronary syndrome (ACS), as well as patients undergoing revascularisation (surgical and percutaneous). They divided their population into two parts: those included in a cardiac rehabilitation program within the first 6 months after discharge (about 11.000 patients, 30,7% of all), and those not included. By propensity score weighting, they corrected for differences in the characteristics of both groups, and obtained a hazard ratio for survival of 0.65.
This retrospective study complements the already strong evidence from randomised trials and systematic reviews, in showing that also in the "real world", when all comers are included in the analysis, cardiac rehabilitation saves lives.
We probably consider it a medical error not to prescribe aspirin or statins to ACS patients, but tend to forget that the effects shown in this (and other) studies proves that cardiac rehabilitation is a life saver, even on top of these medications.
Author: Paul Dendale, EACPR secretary
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