Coronary disease & ACSSecondary analysis
Effectiveness of Multidomain Cardiac Rehabilitation After Myocardial Infarction by Patient Frailty: Prespecified Subgroup Analysis of the PIpELINe Trial
- prespecified subgroup analysis of the PIpELINe (Physical Activity Intervention in Elderly Patients With Myocardial Infarction) randomized clinical trial
- conducted in Italy
- 2:1 ratio
Authors' conclusion
Among older patients recovering from myocardial infarction, frailty is associated with worse prognosis but does not diminish the benefit of multidomain CR. These findings support the use of frailty assessment to guide rather than limit access to CR.
Study context
- Population
- Patients aged ≥65 years recovering from myocardial infarctionenrolled, 350 (68.4%) classified as prefrail/frail, of whom 232 randomized to intervention arm (66%)
- Participants
- 512 patients
- Comparison
- Prefrail/frail vs robust patients; multidomain cardiac rehabilitation (CR) vs usual care, with treatment-by-frailty interaction
- prefrail/frailn = 350
- Primary endpoint
- Composite of:
- Cardiovascular death
- Unplanned hospitalization for cardiovascular causes
- Follow-up
- Within 1 year after randomization
Primary result
As reported in the abstract
Hazard ratio (95% CI)P value
prefrail/frail vs robust
1.59(0.89–2.82)
adjusted P =0.117multidomain CR vs usual careamong prefrail/frail patients
0.57(0.34–0.94)
P = 0.028Further findings
Characteristics of frail patients
- median age, years (frail)
- 80 [75-85]
- female, frail versus other
- 41.7% versus 24.7%
Original publication
Effectiveness of Multidomain Cardiac Rehabilitation After Myocardial Infarction by Patient Frailty: Prespecified Subgroup Analysis of the PIpELINe Trial. Circ Popul Health Outcomes. Published 17 August 2026. doi:10.1161/circoutcomes.126.013410
Summarised from the published abstract; every number is checked against it