SWEDEHEART: na een eerste hartinfarct is fysieke fitheid bij start cardiale revalidatie ver onder de norm

<sec><st>Purpose</st> <p>The primary aim of this study was to describe physical fitness in a large real-world cohort of patients entering exercise-based cardiac rehabilitation (EBCR) after first-time myocardial infarction (MI). The secondary aim was to compare the results with clinical reference values.</p> </sec> <sec><st>Methods</st> <p>This registry-based cohort study used data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) post-MI registry between 2016 and 2019. Patients with first-time MI who underwent physiotherapist-led assessments of physical fitness at EBCR entry were included. Exercise capacity was evaluated by a symptom-limited cycle ergometer test and muscular endurance by a unilateral heel-rise test. Results were compared with age-stratified and sex-stratified clinical reference values. Reference values for exercise capacity were based on the Swedish Kalmar dataset, the national standard reference in Sweden since 2014, and reference values for heel-rise performance were based on a Swedish normative dataset of healthy adults.</p> </sec> <sec><st>Results</st> <p>A total of 15 105 patients (mean age 62.5&plusmn;9.1 years, 78.4% men) were included. Exercise capacity (Watt max from the exercise test) was higher in men than women across age groups, and muscular endurance declined with age, with a steeper age-related decline in women&rsquo;s heel rise performance. The mean exercise capacity of the study population corresponded to 64.7&plusmn;27.4% of predicted values in men and 68.4&plusmn;18.9% in women. Muscular endurance averaged 78.4%&plusmn;51.0% of reference values in men and 61.7%&plusmn;43.2% in women.</p> </sec> <sec><st>Conclusion</st> <p>At EBCR entry after a first-time MI, both exercise capacity and muscular endurance were substantially below age-specific and sex-specific reference values. These results underscore the importance of systematic baseline assessments and tailored rehabilitation interventions targeting both exercise capacity and muscular endurance.</p> </sec>