INTRODUCTION AND OBJECTIVES: Very little information is available on the effect of cardiac rehabilitation programs on long-term survival. The primary aim of this study was to assess the effect of a structured cardiac rehabilitation program on mortality in patients who had suffered acute myocardial infarction. The secondary endpoint was the effect on morbidity. PATIENTS AND METHOD: The study included 180 low-risk male patients aged under 65 years. Patients were randomly assigned to one of 2 groups: 90 entered into a comprehensive cardiac rehabilitation program, and 90 served as a control group. The mean follow-up period was 10 years. RESULTS: All-cause mortality was significantly lower in the intervention group: the 10-year survival rate was 91.8% in the intervention group compared with 81.7% in the control group (p = 0.04). There was also a decrease in cardiovascular mortality, though it was not statistically significant: the 10-year survival rate was 91.8% in the intervention group compared with 83.8% in the control group (p = 0.10). The incidence of non-fatal complications was lower in the intervention group (35.2% versus 63.2%, p = 0.03), as was the incidence of unstable angina (15.7% versus 33.9%, p = 0.02) and cardiac heart failure (3.0% versus 14.4%, p = 0.02), and the need for coronary intervention (8.4% versus 22.9%, p = 0.02). CONCLUSIONS: The application of a comprehensive cardiac rehabilitation program significantly decreased long-term mortality and morbidity in low-risk patients after acute myocardial infarction.

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