Return to work after acute ST-segment elevation myocardial infarction in the modern era of reperfusion by direct percutaneous coronary intervention

• Published in: Archives of cardiovascular diseases 2010-05, Vol.103 (5), p.310-316
• Main Authors: Isaaz, Karl, Coudrot, Maud, Sabry, Mohamed H, Cerisier, Alexis, Lamaud, Michel, Robin, Christophe, Richard, Laure, Da Costa, Antoine, Khamis, Hazem, Abd-Alaziz, Ahmed, Gerenton, Claude
• Format: Article
• Language: English
• Subjects: Adult; Angioplastie primaire; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiac rehabilitation; Cardiology. Vascular system; Cardiovascular; Chi-Square Distribution; Coronary heart disease; Diseases of the cardiovascular system; Employment; Female; France; Heart; Humans; Infarctus du myocarde; Internal Medicine; Logistic Models; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - rehabilitation; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Platelet Aggregation Inhibitors - therapeutic use; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors; Primary angioplasty; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Reprise du travail; Retrospective Studies; Return to work; Risk Assessment; Risk Factors; Réadaptation cardiaque; Sick Leave; Stent; Stent coronaire; Stents; Time Factors; Treatment Outcome
• ISSN: 1875-2136; 1875-2128
• DOI: 10.1016/j.acvd.2010.04.007

Summary Background Previous studies have evaluated return to work after acute ST-segment elevation myocardial infarction (STEMI) treated medically, after bypass surgery or after percutaneous coronary intervention (PCI) for stable coronary artery disease. However, there are few data regarding return to work after acute STEMI treated by direct PCI. Aims To analyse the factors influencing return to work after STEMI treated by direct PCI. Methods Two hundred consecutive patients who underwent direct PCI for acute STEMI and who were employed at the time of their STEMI were studied. Stents were used in 94% of patients and glycoprotein IIb/IIIa inhibitors in 77%. Results Among the 200 patients, 152 (76%) patients returned to work and 48 (24%) did not. Patients who did not return to work did not differ from those who returned to work in terms of time from onset of chest pain to PCI, STEMI location, left ventricular function, extent of vessel disease, PCI technique and success, completeness of revascularization, duration of hospital stay, intrahospital complications and performance of cardiac rehabilitation. Multivariable analysis showed that older age, daytime onset of chest pain, manual labour, rapid call-out of the emergency medical team, unmarried status and a limited number of risk factors were independent predictors of non-return to work. Conclusion Age, sociopsychological and occupational factors appear to be the strongest predictors of return to work after STEMI treated by direct PCI. Clinical and procedural factors as well as cardiac rehabilitation appear to have no impact on return to work in this subset of patients.