Rapid return to work after heart attack OK for some

Some heart attack survivors may be able to go back to work much sooner than is typically recommended, a preliminary study suggests.

Australian researchers found that certain heart attack patients were able to return to work just two weeks after suffering the attack, without raising their risk of a repeat attack or other complications. The study included only those patients deemed to be at low risk of a second heart attack, based on tests conducted during their hospital stay.

The findings suggest that with the proper tests and patient counseling before hospital discharge, low-risk heart attack survivors can return to work much sooner than the usual six to eight weeks, according to the study authors.

However, larger studies are needed before any broad recommendations can be made, the researchers conclude in a report published in the American Journal of Cardiology.

Typically, doctors advise heart attack patients to wait at least six weeks before returning to work and resuming other normal activities. This is mainly aimed at giving the damaged heart muscle time to recover, but it also allows patients time for a formal cardiac rehabilitation program.

In the current study, Dr. Pramesh Kovoor and colleagues at the University of Sydney and Westmead Hospital evaluated low-risk patients to see if they could forgo a full cardiac rehabilitation program and instead resume their normal lives two weeks after the heart attack.

The researchers randomly assigned half of the 142 patients to a traditional regimen of cardiac rehabilitation and six weeks off of work, while the other half were told they could return to work and other activities after two weeks. Patients in this latter group received weekly calls from the study nurse and, like the rehab patients, were encouraged to exercise at home.

During their hospital stay, patients in both groups received counseling on medication, diet, exercise and other lifestyle issues.

Six months later, Kovoor's team found, the two groups showed no differences in the risk of a repeat heart attack or the need for artery-clearing surgery. Their cholesterol levels, rates of smoking and exercise habits were also similar.

The results suggest that low-risk patients could be offered the option of returning to normal activities, including their jobs, just two weeks after their heart attack, according to Kovoor and his colleagues.

They caution, however, that these patients will need counseling before their hospital discharge to ensure they understand how to cut their risk of future heart problems.

SOURCE: American Journal of Cardiology, April 2006.