Objective: The purpose of this study is to establish a hypothesis that a longer period of time would be required for older patients compared with younger patients, and to compare the degree of improvement according to time with older and younger patients.
Methods: This retrospective study analyzed the medical records of 70 patients diagnosed with AMI (ST elevation and non-ST elevation myocardial infarction) between January 2011 and September 2017 who were referred to our rehabilitation center after undergoing percutaneous coronary intervention (PCI). Among the patients who underwent exercise tolerance test (ETT) at about 3 weeks after the onset of AMI (T0), about 6 weeks after completion of the first ETT (T1) and about 12 weeks after completion of the first ETT (T2). We divided patients older than 65 years were grouped into older group (24 patients) and the others were grouped into younger group (46 patients). (Table 1.) Study outcomes were estimated from the ETT at both aforementioned assessment points.
Results: The younger group showed improvement of METsmax and VO2max between T0 and T1. However older group showed no significant improvement between T0 and T1. The exercise capacity (METsmax and VO2max) of all groups showed improvement between T0 and T2. METsmax of younger group was 6.08±0.75 at baseline and 7.52±1.66 after 12 weeks, VO2max of younger group was 1.525±0.297 at base line and 1.888±0.511 after 12 weeks. METsmax of older group was 5.18±1.32 at baseline and 6.29±2.00 after 12 weeks, VO2max of older group was 1.120±0.355 at base line and 1.325±0.470 after 12 weeks. (younger group; p=0.000 , p=0.000, older group; p=0.031, p=0.046) (Table 2., Table 3.)
Conclusion: Patients 65 years of age or younger showed improvement in their ability to exercise through a 6-week CR, whereas those aged 65 and older showed improvement in their ability to exercise over a 6-week, at least 12-week CR. Therefore, elderly patients need more participation periods of CR than younger ones.
Key Words: Cardiac rehabilitation, Old age, Acute myocardial infarction, Exercise capacity, Exercise tolerance test
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