{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:03:41Z","timestamp":1789581821502,"version":"build-2803163510"},"reference-count":32,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Health Minister","doi-asserted-by":"publisher","award":["GR 2018-12367114"],"award-info":[{"award-number":["GR 2018-12367114"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"PIpELINe study"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the prognostic role of physical performance as a marker of vulnerability in older patients after myocardial infarction and its interaction with a multidomain cardiac rehabilitation intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this prespecified subanalysis of the PIpELINe trial, physical performance was evaluated using the Short Physical Performance Battery (SPPB). Patients aged \u226565 years with intermediate SPPB scores (4\u20139) were randomized in a 2:1 ratio to a multidomain rehabilitation programme or usual care. The primary outcome was a composite of cardiovascular death or unplanned hospitalization for cardiovascular causes at 1 year. Associations between baseline SPPB, its individual components, longitudinal changes over time, and clinical outcomes were examined using competing-risk models. Among 512 randomized patients, lower baseline SPPB scores were associated with a significantly higher risk of the primary outcome (HR 0.51, 95% CI 0.32\u20130.82). No interaction was observed between baseline SPPB and treatment assignment, indicating a consistent benefit of intervention across levels of physical performance. Among individual SPPB components, gait speed emerged as the strongest prognostic marker, with an approximately 50% reduction in risk per 1-point increase (HR 0.50, 95% CI 0.37\u20130.68; P &amp;lt; 0.001). Improvement in SPPB of at least one point during follow-up was associated with a lower risk of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In older myocardial infarction patients, baseline physical performance is a strong and independent predictor of adverse cardiovascular outcomes without modifying the benefit of multidomain cardiac rehabilitation. Gait speed represents a simple and pragmatic marker of risk, and functional improvement over time is associated with better prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03021044<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag390","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:14:33Z","timestamp":1789384473000},"source":"Crossref","is-referenced-by-count":0,"title":["Physical performance and outcomes after myocardial infarction in older patients undergoing multidomain cardiac rehabilitation"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-4534","authenticated-orcid":false,"given":"Andrea","family":"Raisi","sequence":"first","affiliation":[{"name":"Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara , Ferrara (FE) 44121 ,","place":["Italy"]},{"name":"Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, University of Illinois at Chicago , Chicago, IL 60607 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1002-8886","authenticated-orcid":false,"given":"Valentina","family":"Zerbini","sequence":"additional","affiliation":[{"name":"Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara , Ferrara (FE) 44121 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0257-1272","authenticated-orcid":false,"given":"Elisabetta","family":"Tonet","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara , Via Aldo Moro 8, Ferrara (FE) 44124 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,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8695-7902","authenticated-orcid":false,"given":"Giovanni","family":"Pasanisi","sequence":"additional","affiliation":[{"name":"Cardiological Rehabilitation, Ospedale del Delta , Via Valle Oppio 2, Lagosanto (FE) 44023 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Emanuela","family":"D\u2019Intino","sequence":"additional","affiliation":[{"name":"Sport Medicine, AUSL Bologna , Via Cimarosa 5\/2, Casalecchio di Reno (BO) 40033 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-9711","authenticated-orcid":false,"given":"Rita","family":"Pavasini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara , Via Aldo Moro 8, Ferrara (FE) 44124 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