Registry study from the Swedish SWEDEHEART post-MI register (2016-2019) in 15,105 patients with first-time myocardial infarction (mean age 62.5 years; 78.4% male) who underwent physiotherapist-led assessments of exercise capacity (symptom-limited cycle ergometry) and muscular endurance (unilateral heel-rise test) at the start of cardiac rehabilitation. Results were compared with Swedish age- and sex-stratified reference values (Kalmar dataset). Mean exercise capacity was only 64.7% of predicted in men and 68.4% in women; muscular endurance 78.4% in men and 61.7% in women. Women showed a steeper age-related decline in heel-rise performance. The results underscore the importance of systematic baseline assessment and tailored rehabilitation targeting both exercise capacity and muscle strength.
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.
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.
A total of 15 105 patients (mean age 62.5±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’s heel rise performance. The mean exercise capacity of the study population corresponded to 64.7±27.4% of predicted values in men and 68.4±18.9% in women. Muscular endurance averaged 78.4%±51.0% of reference values in men and 61.7%±43.2% in women.
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.
