Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Tue, Sep 8, 2026
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Volume 40, Issue 1 (1-2026)
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Dabiri A, Nikoo M, Mozayanimonfared A, Pirdehghan A, Ghiasvandi S, Majidi L. Timing of Cardiac Rehabilitation After Primary Percutaneous Coronary Intervention for Myocardial Infarction: A Randomized Clinical Trial. Med J Islam Repub Iran 2026; 40 (1) :736-744
URL: http://mjiri.iums.ac.ir/article-1-9890-en.html
URL: http://mjiri.iums.ac.ir/article-1-9890-en.html
Ashkan Dabiri 
, Mohammadreza Nikoo , Azadeh Mozayanimonfared , Azar Pirdehghan , Saeed Ghiasvandi , Lobat Majidi
, Mohammadreza Nikoo , Azadeh Mozayanimonfared , Azar Pirdehghan , Saeed Ghiasvandi , Lobat Majidi
Department of Physical Medicine and Rehabilitation, School of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran , lobat.majidi@gmail.com
Abstract: (140 Views)
Background: Cardiac rehabilitation (CR) is a cornerstone of post-acute care for patients experiencing cardiovascular events or interventions. It aims to improve cardiorespiratory capacity, enhance quality of life, and maximize physical function, facilitating a return to daily activities. However, the optimal timing for initiating CR following acute coronary events or procedures remains uncertain.
Methods: In this randomized clinical trial, 40 patients diagnosed with acute myocardial infarction and treated with primary percutaneous coronary intervention (PCI) were randomly assigned to two groups. Group A commenced cardiac rehabilitation one month after PCI, while Group B initiated rehabilitation two months post-PCI. Both groups completed a supervised 12-session rehabilitation program under the guidance of a physical medicine specialist. Functional outcomes were assessed before and after rehabilitation using the SF-36 quality of life questionnaire and echocardiographic parameters. Data were analyzed using SPSS version 25. Within-group changes were evaluated with paired t-tests, and between-group comparisons of change scores were conducted using independent samples t-tests. A P-value < 0.05 was considered statistically significant.
Results: Post-rehabilitation, the mean SF-36 score was 65.85±6.67 in Group A and 67.05±5.96 in Group B (P=0.192). The mean change in Left Ventricular Ejection Fraction (LVEF) was 2.25% in Group A and 0.15% in Group B (P=0.305). After rehabilitation, grade 1–2 diastolic dysfunction remained present in 85% of patients in both groups, while 15% of patients in each group showed no evidence of diastolic dysfunction (P=0.506).No significant differences were found between groups in heart rate (HR) Max (107.45±15.04 vs. 115.20±13.12; P=0.091), HR Recovery (22.50±7.05 vs. 23.10±7.78; P=0.800), or MET change (6.60±1.83 vs. 6.20±2.39; P=0.556).
Conclusion: Initiating cardiac rehabilitation one month as opposed to two months after primary PCI did not yield significant differences in quality of life or cardiac functional parameters. These findings indicate that there may be flexibility in the timing of CR initiation without compromising short-term functional outcomes.
Methods: In this randomized clinical trial, 40 patients diagnosed with acute myocardial infarction and treated with primary percutaneous coronary intervention (PCI) were randomly assigned to two groups. Group A commenced cardiac rehabilitation one month after PCI, while Group B initiated rehabilitation two months post-PCI. Both groups completed a supervised 12-session rehabilitation program under the guidance of a physical medicine specialist. Functional outcomes were assessed before and after rehabilitation using the SF-36 quality of life questionnaire and echocardiographic parameters. Data were analyzed using SPSS version 25. Within-group changes were evaluated with paired t-tests, and between-group comparisons of change scores were conducted using independent samples t-tests. A P-value < 0.05 was considered statistically significant.
Results: Post-rehabilitation, the mean SF-36 score was 65.85±6.67 in Group A and 67.05±5.96 in Group B (P=0.192). The mean change in Left Ventricular Ejection Fraction (LVEF) was 2.25% in Group A and 0.15% in Group B (P=0.305). After rehabilitation, grade 1–2 diastolic dysfunction remained present in 85% of patients in both groups, while 15% of patients in each group showed no evidence of diastolic dysfunction (P=0.506).No significant differences were found between groups in heart rate (HR) Max (107.45±15.04 vs. 115.20±13.12; P=0.091), HR Recovery (22.50±7.05 vs. 23.10±7.78; P=0.800), or MET change (6.60±1.83 vs. 6.20±2.39; P=0.556).
Conclusion: Initiating cardiac rehabilitation one month as opposed to two months after primary PCI did not yield significant differences in quality of life or cardiac functional parameters. These findings indicate that there may be flexibility in the timing of CR initiation without compromising short-term functional outcomes.
Keywords: Cardiac rehabilitation, myocardial infarction, PCI, timing, functional recovery, quality of life
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