Pain, Low Muscle Mass, and Exercise Participation After Myocardial Infarction: Determinants of Initial Exercise Testing at a Tertiary Center Serving a Rural Region

Background/Objectives: Musculoskeletal pain and balance impairments are common in patients referred for cardiac rehabilitation (CR), but their influence on early exercise participation and aerobic capacity remains unclear. This study examined whether pain and muscle mass are associated with initial exercise tolerance test (ETT) participation and VO2 peak.

Methods

This retrospective, single-center cohort included 162 of 189 patients referred to CR after percutaneous coronary intervention for acute myocardial infarction; 105 who completed a symptom-limited cardiopulmonary exercise test were analyzed for VO2 peak. Pain intensity was assessed using a visual analog scale (VAS 0–10), and the skeletal muscle index (SMI) was measured using a bioelectrical impedance analysis. Determinants of ETT participation and VO2 peak were evaluated using multivariable logistic and linear regressions, respectively, with pain analyzed as a binary, three-category, and continuous variable.