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A controlled trial of physical training after myocardial infarction. Effects on risk factors, nonfatal reinfarction, and death
Wilhelmsen L, Sanne H, Elmfeldt D, Grimby G, Tibblin G, Wedel H
Preventive Medicine 1975 Dec;4(4):491-508
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The purpose of the trial was to analyze whether supervised physical training could reduce death and nonfatal reinfarction in a nonselected series of postinfarct patients. All patients born in 1913 and later, who were hospitalized for a myocardial infarction during 1968 to 1970 in Goteborg Sweden, were randomized to a training group (158 patients) and a control (157 patients). Other treatment was exactly the same and standardized for the two groups. Twenty-seven percent were excluded from training. Training started 3 months after the infarct and was scheduled for three times a week. The training group had higher physical working capacity after 1 yr than the control group. Blood pressure was lower, but there was no differences in blood lipids. During 4 yr of follow-up, 28 patients died in the training group and 35 in the control group. The numbers of nonfatal reinfarcts were 25 and 28, respectively. Within the training group patients adhering to the program had lower mortality than those who did not, but the former also had lower initially predicted risk of dying. A special analysis of patients who attended the training program in comparison to matched controls also showed a lower mortality. No differences in mortality between the training group and the control group were statistically significant, however.
Copyright by Academic Press.

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