An intensive, comprehensive, long-term secondary prevention program lasting up to three years after cardiac rehabilitation appears to reduce the risk of a second non-fatal heart attack and other cardiovascular events, according to a report in the November 10 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Cardiac rehabilitation programs after a heart disease diagnosis have evolved over two decades from solely exercise-based interventions, according to background information in the article. Now, rehabilitation includes helping patients with smoking cessation, diet, risk factors, and lifestyle habits. However, current rehabilitation procedures rely on short-term interventions that are unlikely to yield long-term benefits because patients never reach therapeutic goals.
Pantaleo Giannuzzi, M.D., of the Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy, and colleagues conducted the Global Secondary Prevention Strategies to Limit Event Recurrence After Myocardial Infarction (GOSPEL) study, in which they randomly assigned 1,620 patients who had a heart attack to receive a long-term, reinforced, multifactorial educational and behavioral intervention after a standard period of rehabilitation.
“The intervention was aimed at individualizing risk factor and lifestyle management, and pharmacological treatments were based on current guidelines,” the authors write. Comprehensive sessions with one-on-one support were held monthly for six months, then once every six months for three years. Results of patients in this program were compared with those of 1,621 who were randomly assigned to receive usual care.