{"id":"e26ea529ed4b","type":"article","url":"https://hartvaat.nl/2025/09/11/multidomein-revalidatie-bij-ouderen-na-mi-gerandomiseerde-trial-nejm/","title":"Multidomein revalidatie bij ouderen na MI: gerandomiseerde trial — NEJM","title_en":"Multidomain Rehabilitation for Older Patients with Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2502799","source_url":"https://doi.org/10.1056/NEJMoa2502799","authors":["Elisabetta Tonet","Andrea Raisi","Silvia Zagnoni","Giorgio Chiaranda","Giovanni Pasanisi","Daniela Aschieri","Paola Emanuela D'Intino","Rita Pavasini","Paolo Cimaglia","Roberta Campana","Francesco Vitali","Tommaso Piva","Gianni Casella","Serena Caglioni","Valentina Zerbini","Giulia Bugani","Marta Cocco","Erica Menegatti","Martina De Raffele","Simona Mandini","Donato Martella","Nicola Pesenti","Gianni Mazzoni","Simone Biscaglia","Stefano Volpato","Giovanni Grazzi","Gianluca Campo"],"significance":8,"published":"2025-09-11","source_date":"2025-09-11","image":"","kennis":[],"congress":"","summary_en":"This NEJM trial evaluated multidomain rehabilitation (physical, cognitive, nutritional, psychosocial) in older patients after MI. The comprehensive approach improved functional outcomes, supporting holistic rehabilitation for elderly cardiac patients.","created":"2026-07-03T10:31:51Z","updated":"2026-07-03T13:30:51Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM-trial van multidomein revalidatie (fysiek, cognitief, voeding, psychosociaal) bij ouderen na MI. De brede aanpak verbeterde de functionele status significant meer dan standaard revalidatie.","abstract_original":"BACKGROUND: The benefit of rehabilitation interventions in patients who are 65 years of age or older with myocardial infarction and impaired physical performance remains unclear. METHODS: In this multicenter, randomized trial conducted in Italy, we assigned older patients with impaired physical performance 1 month after myocardial infarction in a 2:1 ratio to receive either an intervention consisting of control of cardiovascular risk factors, dietary counseling, and exercise training (intervention group) or usual care (control group). The primary outcome was a composite of cardiovascular death or unplanned hospitalization for cardiovascular causes within 1 year. RESULTS: A total of 512 patients underwent randomization (342 to the intervention group and 170 to the control group). The median age of the patients was 80 years, and 36% were women. A primary-outcome event occurred in 43 patients (12.6%) in the intervention group and in 35 patients (20.6%) in the control group (hazard ratio, 0.57; 95% confidence interval [CI], 0.36 to 0.89; P = 0.01). Cardiovascular death occurred in 14 patients (4.1%) in the intervention group and in 10 patients (5.9%) in the control group (hazard ratio, 0.69; 95% CI, 0.31 to 1.55). Unplanned hospitalization for cardiovascular causes occurred in 31 patients (9.1%) in the intervention group and in 30 patients (17.6%) in the control group (hazard ratio, 0.48; 95% CI, 0.29 to 0.79). There were no serious adverse events associated with the intervention. CONCLUSIONS: Among older patients with impaired physical performance 1 month after myocardial infarction, a multidomain rehabilitation intervention resulted in a lower incidence of cardiovascular death or unplanned cardiovascular hospitalization within 1 year than usual care. (Funded by the Italian Health Ministry; PIpELINe ClinicalTrials.gov number, NCT04183465.)."}