EFFECTIVENESS OF CARDIAC REHABILITATION AFTER MYOCARDIAL INFARCTION: A SYSTEMATIC REVIEW OF SURVIVAL AND QUALITY OF LIFE OUTCOMES
DOI:
https://doi.org/10.56238/levv16n54-017Keywords:
Myocardial Infarction, Cardiac Rehabilitation, Quality of Life, MortalityAbstract
Introduction: Myocardial infarction remains a major global cause of death and disability, and cardiac rehabilitation is a cornerstone of secondary prevention aimed at improving survival and health-related quality of life.
Objective: To evaluate the effectiveness of multidisciplinary cardiac rehabilitation in improving survival and health-related quality of life after myocardial infarction, and to compare outcomes across delivery models, programme components, and key patient subgroups.
Methods: We conducted a systematic review following PRISMA 2020 across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP (January 2016–December 2025). Eligible studies enrolled adults with confirmed myocardial infarction, compared structured cardiac rehabilitation with usual care or no rehabilitation, and reported survival and/or validated quality-of-life outcomes. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment; certainty was appraised using GRADE.
Results and Discussion: Twenty-two studies were included, encompassing randomized trials, cohort analyses, and meta-analyses focused on post–myocardial infarction populations. Participation and especially completion of rehabilitation were consistently associated with lower all-cause and cardiovascular mortality, fewer rehospitalisations, and clinically relevant improvements in exercise capacity and health-related quality of life. Home-based, hybrid, and tele-rehabilitation models were generally non-inferior to centre-based programmes, supporting flexible delivery without loss of efficacy. Benefits were observed across age groups, with emerging data supporting circadian-sensitive scheduling and comprehensive psychosocial integration. Heterogeneity in programme intensity, duration, and components explains variability in effect sizes; overall certainty of evidence was moderate to high for mortality and moderate for quality-of-life outcomes.
Conclusion: Cardiac rehabilitation after myocardial infarction confers clinically meaningful gains in survival and health-related quality of life. Routine referral at discharge, strategies to optimise adherence and completion, and scalable hybrid or home-based models should be prioritised to expand equitable access and durability of benefits.
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