Infarto miocardico e lavoro: individuazione dei fattori che influenzano l'outcome lavorativo.

The timing of return to work after a myocardial infarction (AMI) is influenced by many factors (angina pectoris, noncardiovascular comorbidities, left ventricle ejection fraction, stress test performance). It is also influenced by professional risk and work-related energy expenditure level. A quick resumption of ordinary occupational activities may cause a worsening of psychological and physical conditions and quality of life with an increased risk for health and safety at work. The aim of this study is to evaluate the working-outcome in 124 patients at three months from an acute myocardial infarction (AMI) and identify individual, clinical and procedural factors related to it. The working outcome was assessed by the Work Performance Scale (WPS) of the Functional Status Questionnaire (FSQ) in order to study the level of disability and monitor the functional capacity of the patients. Clinical variables evaluated were the left ventricular ejection fraction (EF), performing a cardiac rehabilitation program and the functional capacity measured at a stress test. Statistical analysis (Student's t test for unpaired data with p <0.05) showed that the WPS score were lower in patients who had a decline in ejection fraction at discharge, reduced functional capacity, and had not perform a cardiac rehabilitation program after a heart attack. These factors are consistently associated with a worse working-outcome. This suggests the benefits of a close collaboration between cardiologist and specialist in occupational medicine.