PT - JOURNAL ARTICLE AU - Gianluca Campo AU - Elisabetta Tonet AU - Giorgio Chiaranda AU - Gianluigi Sella AU - Elisa Maietti AU - Giulia Bugani AU - Francesco Vitali AU - Matteo Serenelli AU - Gianni Mazzoni AU - Rossella Ruggiero AU - Giovanni Villani AU - Simone Biscaglia AU - Rita Pavasini AU - Andrea Rubboli AU - Roberta Campana AU - Serena Caglioni AU - Stefano Volpato AU - Jonathan Myers AU - Giovanni Grazzi TI - Exercise intervention improves quality of life in older adults after myocardial infarction: randomised clinical trial AID - 10.1136/heartjnl-2019-316349 DP - 2020 Nov 01 TA - Heart PG - 1658--1664 VI - 106 IP - 21 4099 - http://heart.bmj.com/content/106/21/1658.short 4100 - http://heart.bmj.com/content/106/21/1658.full SO - Heart2020 Nov 01; 106 AB - Objective To establish the benefits of an early, tailored and low-cost exercise intervention in older patients hospitalised for acute coronary syndrome (ACS).Methods The study was a multicentre, randomised assessment of an exercise intervention in patients with ACS ≥70 years with reduced physical performance (as defined by the short physical performance battery (SPPB), value 4–9). The exercise intervention included four supervised sessions (1, 2, 3, 4 months after discharge) and home-based exercises. The control group attended a health education programme only. The outcomes were the 6-month and 1-year effects on physical performance, daily activities, anxiety/depression and quality of life. Finally, 1-year occurrence of adverse events was recorded.Results Overall, 235 patients with ACS (median age 76 (73–81) years) were randomised 1 month after ACS. Exercise and control groups were well balanced. Exercise intervention improved 6-month and 1-year grip strength and gait speed. Exercise intervention was associated with a better quality of life (as measured by EuroQol-visual analogue scale at 6 months 80 (70–90) vs 70 (50–80) points, p<0.001 and at 1 year 75 (70–87) vs 65 (50–80) points, p<0.001) and with a reduced perception of anxiety and/or depression (6 months: 21% vs 42%, p=0.001; 1 year 32% vs 47%, p=0.03). The occurrence of cardiac death and hospitalisation for cardiac cause was lower in the intervention group (7.5% vs 17%, p=0.04).Conclusions The proposed early, tailored, low-cost exercise intervention improves mobility, daily activities, quality of life and outcomes in older patients with ACS. Larger studies are needed to confirm the clinical benefit.Trial registration number NCT03021044.