Introduction: Myocardial infarction is the leading manifestation of ischemic heart disease. With adequate treatment and adherence to secondary prevention measures, cardiovascular rehabilitation has a beneficial effect on the survival, morbidity, and quality of life of patients.

Aim: To present the recovery of patients after myocardial infarction who were included in the outpatient cardiovascular rehabilitation program.

Materials and methods: Data from discharge letters and medical histories of 474 patients who, after their first myocardial infarction, were included in the standard outpatient cardiovascular rehabilitation program were retrospectively analyzed. The following data were collected: demographic data (age and gender), time from myocardial infarction to the moment of inclusion in the cardiovascular rehabilitation program in days, anamnestic data on the presence of cardiovascular risk factors (arterial hypertension, dyslipidemia, cigarette smoking, diabetes, body mass index), positive family history, and the presence of comorbidities. The Hospital Anxiety and Depression Scale was used for self- assessment of anxiety and depression at admission and discharge. Data were also collected on the number of participants in therapeutic exercise and the results of load tolerance in ergometric testing upon admission and discharge from the cardiovascular rehabilitation program.

Results: Patients in the youngest age group (30 to 50 years) started rehabilitation on average after 69.5 days, and the oldest patients (>70) only after 107 days from myocardial infarction. The most common risk factors were dyslipidemia (85.6%) and a body mass index value higher than 25 (85.2%). Increased anxiety was registered in 9.7% and depression in 10.6% of patients upon admission, and upon discharge, anxiety decreased to 5.9% and depression to 7.8%. Patients under the age of 60 years came more regularly compared to patients in the older age group (p=0.005). Analysis of the results of ergometric testing by gender determined that women achieved a statistically lower load in METs compared to men in testing upon admission and upon discharge from the program (p=0.000).

Conclusion: It is necessary to educate patients about the importance of timely and regular participation in a standard outpatient cardiovascular rehabilitation program and the need to continue physical activity after rehabilitation.

Key words: acute myocardial infarction, cardiovascular rehabilitation, anxiety, depression, physical activity

Uvod: Akutni infarkt miokarda vodeća je manifestacija ishemijske bolesti srca. Uz adekvatno liječenje i pridržavanje mjera sekundarne prevencije, kardiovaskularna rehabilitacija povoljno utječe na preživljavanje, pobol i kvalitetu života kardioloških bolesnika.

Cilj: Prikazati oporavak bolesnika nakon akutnog infarkta miokarda koji su bili uključeni u program ambulantne kardiovaskularne rehabilitacije.

Materijali i metode: Retrospektivno su analizirani podaci iz otpusnih pisama i povijesti bolesti 474 bolesnika koji su, nakon prvog akutnog infarkta miokarda, bili uključeni u standardni program ambulantne kardiovaskularne rehabilitacije. Prikupljeni su sljedeći podaci: demografski podaci (dob i spol), vrijeme od akutnog infarkta miokarda do trenutka uključenja u program kardiovaskularne rehabilitacije u danima, anamnestički podaci o prisutnostima čimbenika kardiovaskularnog rizika (arterijskoj hipertenziji, dislipidemiji, pušenju cigareta, dijabetesu, vrijednosti indeksa tjelesne mase), pozitivna obiteljska anamneza te prisutnost komorbiditeta. Za samoprocjenu anksioznosti i depresivnosti korištena je Ljestvica bolničke anksioznosti i depresije kod prijema i otpusta. Prikupljeni su i podaci o broju sudjelovanja na terapijskom vježbanju te rezultati podnošenja opterećenja na ergometrijskom testiranju kod prijema i otpusta iz programa kardiovaskularne rehabilitacije.

Rezultati: Bolesnici najmlađe dobne skupine (od 30 do 50 godina) prosječno su započeli rehabilitaciju nakon 69,5 dana, a najstariji bolesnici (>70) tek nakon 107 dana od akutnog infarkta miokarda. Najčešći čimbenici rizika bili su displidemija (85,6 %) i vrijednost indeksa tjelesne mase viša od 25 (85,2 %), Povišena anksioznost bila je registrirana kod 9,7 % a depresivnost kod 10.6% bolesnika prilikom prijema a, prilikom otpusta se anksioznost smanjila na 5,9%, a depresivnost na 7,8%. Bolesnici u dobi do 60 godina redovitije dolaze u odnosu na bolesnike starije dobne skupine (p=0,005). Analiza rezultata ergometrijskog testiranja prema spolu utvrdila je da žene postižu statistički manje opterećenje u MET ima u odnosu na muškarce u testiranju kod prijema i prilikom otpusta iz programa (p=0,000).

Zaključak: Potrebno je educirati bolesnike o važnosti pravovremenog i redovitog sudjelovanja u standardnom programu ambulantne kardiovaskularne rehabilitacije te o potrebi nastavka tjelesne aktivnosti i nakon rehabilitacije.

Ključne riječi: akutni infarkt miokarda, kardiovaskularna rehabilitacija, anksioznost, depresija, tjelesna aktivnost