Coronary disease & ACS

Physical performance and outcomes after myocardial infarction in older patients undergoing multidomain cardiac rehabilitation

Eur J Prev CardiolPublished Secondary analysis of the PIpELINe randomised trial

Primary result · Primary outcome by baseline SPPBResult — go to the resultHazard ratio 0.51 95% CI 0.32–0.82

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
Baseline physical performance (SPPB) and outcomes; multidomain rehabilitation vs usual care
Primary endpoint
Composite of:
  • CV death
  • Unplanned hospitalisation for CV causes
Follow-up
1 year
Methodological detailsprespecified subanalysis, 2:1 randomisation, competing-risk models
  • Prespecified subanalysis
  • 2:1 randomisation
  • Competing-risk models

Primary result

Primary outcome by baseline SPPB

Hazard ratio

0.51

95% CI 0.32–0.82

Baseline SPPB
HR 0.51 (95% CI 0.32–0.82)

As reported in the abstract

Further findings

OutcomeHR (95% CI)P value
Primary outcome by gait speed (SPPB component), per 1-point increasePer 1-point increase; strongest prognostic marker0.50 (0.37–0.68)P < 0.001

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

Composed by AI from the published abstract and checked against it. How Briefs are made →

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