Overview
This study evaluates if remote video exercise-based cardiac rehabilitation (exCR), offered as an alternative to centre-based exCR, can increase the proportion of patients post myocardial infarction (MI) successfully completing an exCR-program.
Description
Primary aim is to evaluate if remote video exCR, offered as an alternative to centre-based exCR, can increase the proportion of patients post myocardial infarction (MI) successfully completing an exCR-program.
Secondary aims are to investigate if remote video exCR is at least as effective as centre-based exCR, in terms of physical fitness, patient-reported outcome measures (PROMs) and cost-effectiveness. Follow-up of cardiovascular events (all-cause mortality, cardiovascular mortality, recurrent hospitalization for acute coronary syndrome (ACS), heart failure and stroke, and repeat coronary revascularization) will be performed.
CR centers (not patients) will be cluster randomized to either the intervention or control. Patients at intervention centers will be offered remote video exCR or usual care centre-based exCR, as self-preferred choice. At control centers, patients will be offered usual care centre-based exCR only. The duration of each time period for each center will be approximately 15 months.
A number of 1500 of eligible patients post MI, meeting the inclusion and exclusion criteria over a period of approximately three years.
Eligibility
Inclusion Criteria:
- Written informed consent
- Diagnosis of acute myocardial infarction (AMI)
- Age 18-79 years at discharge from hospital
Exclusion Criteria:
- Patients with incomplete coronary revascularization defined as at least one remaining hemodynamically significant stenosis
- Severe valve or structural heart disease
- Severe heart failure (NYHA IIIb - IV)
- Inability to understand Swedish
- No internet access at home (only applicable for intervention group)
- Any condition that may interfere with the possibility for the patient to comply with the study protocol