Poor Implementation of Cardiac Rehabilitation Despite Broad Dissemination of Coronary Interventions for Acute Myocardial Infarction in Japan A Nationwide Survey

Yoichi Goto; Muneyasu Saito; Toshiji Iwasaka; Hiroyuki Daida; Masahiro Kohzuki; Kenji Ueshima; Shigeru Makita; Hitoshi Adachi; Hiroyoshi Yokoi; Kazuto Omiya; Hiroshi Mikouchi; Hiroyuki Yokoyama; The Japanese Cardiac Rehabilitation Survey Investigators

doi:10.1253/circj.71.173

Clinical Investigation

Poor Implementation of Cardiac Rehabilitation Despite Broad Dissemination of Coronary Interventions for Acute Myocardial Infarction in Japan

A Nationwide Survey

Yoichi Goto, Muneyasu Saito, Toshiji Iwasaka, Hiroyuki Daida, Masahiro Kohzuki, Kenji Ueshima, Shigeru Makita, Hitoshi Adachi, Hiroyoshi Yokoi, Kazuto Omiya, Hiroshi Mikouchi, Hiroyuki Yokoyama, The Japanese Cardiac Rehabilitation Survey Investigators

Author information

Yoichi Goto
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Muneyasu Saito
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Toshiji Iwasaka
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Hiroyuki Daida
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Masahiro Kohzuki
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Kenji Ueshima
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Shigeru Makita
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Hitoshi Adachi
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Hiroyoshi Yokoi
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Kazuto Omiya
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Hiroshi Mikouchi
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
Hiroyuki Yokoyama
The Japanese Cardiac Rehabilitation Survey Investigators are listed in Appendix 1.
The Japanese Cardiac Rehabilitation Survey Investigators

Keywords: Acute myocardial infarction, Cardiac rehabilitation, Exercise prescription, Percutaneous coronary intervention

JOURNAL FREE ACCESS

2007 Volume 71 Issue 2 Pages 173-179

DOI https://doi.org/10.1253/circj.71.173

Details

Abstract

Background The implementation of cardiac rehabilitation (CR) after acute myocardial infarction (AMI) has not been fully investigated in Japan, so a nationwide survey of hospitals was conducted. Methods and Results Questionnaires were sent in 2004 to a total of 1,875 hospitals in Japan, including all the 859 Japanese Circulation Society (JCS)-authorized cardiology-training hospitals (THs), 311 JCS-associated hospitals (AH), and 705 randomly sampled non-THs (NTHs). The response rate was 59% (1,106/1,875). The percentages of hospitals treating hospitalized AMI patients were 97% in 526 TH, 85% in 194 AH, and 20% in 339 NTH. Although the rates of implementation of emergency percutaneous coronary intervention were very high (92%, 56%, and 4%, respectively), the rates of implementation of recovery phase CR were low (20%, 8%, and 2%, respectively). In addition, patient education programs (23%, 13% and 2%) and formulated exercise prescriptions based on exercise testing (16%, 7% and 1%) were poorly implemented. More importantly, only 9%, 2% and 0% of these hospitals had outpatient CR programs. From these data, the nationwide participation rate in outpatient CR after AMI in Japan was estimated to be only 3.8-7.6%. Conclusion This first nationwide survey demonstrated that, in contrast to the broad dissemination of acute phase invasive treatment for AMI, the implementation of recovery phase CR, especially outpatient CR, is extremely poor in Japan. In addition, patient education programs and exercise prescription based on exercise testing are only poorly implemented. (Circ J 2007; 71: 173 - 179)

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