Coronary disease & ACSSecondary analysis
Physical performance and outcomes after myocardial infarction in older patients undergoing multidomain cardiac rehabilitation
- Secondary analysis of the PIpELINe randomised trial
- prespecified subanalysis
- 2:1 randomisation
- competing-risk models
Authors' conclusion
In older myocardial infarction patients, baseline physical performance is a strong and independent predictor of adverse cardiovascular outcomes without modifying the benefit of multidomain cardiac rehabilitation. Gait speed represents a simple and pragmatic marker of risk, and functional improvement over time is associated with better prognosis.
Study context
- Population
- Patients aged ≥65 years after MI with intermediate Short Physical Performance Battery (SPPB) scores (4–9)randomised
- Participants
- 512 patients
- Comparison
- Multidomain rehabilitation vs Usual care
- Primary endpoint
- Composite of:
- CV death
- Unplanned hospitalisation for CV causes
- Follow-up
- 1 year
Primary result
Primary outcome by baseline SPPB
Hazard ratio
0.51
95% CI 0.32–0.82
Baseline SPPB vs Usual care
HR 0.51 (95% CI 0.32–0.82)
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Primary outcome by gait speed (SPPB component), per 1-point increase · per 1-point increase; strongest prognostic marker | 0.50 (0.37–0.68) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Interaction between baseline SPPB and treatment assignment
- No interaction; consistent benefit of intervention across levels of physical performance
SPPB improvement ≥1 point during follow-up
- Associated with lower risk of adverse outcomes
Original publication
Physical performance and outcomes after myocardial infarction in older patients undergoing multidomain cardiac rehabilitation. Eur J Prev Cardiol. Published 16 September 2026. doi:10.1093/eurjpc/zwag390
Summarised from the published abstract; every number is checked against it