Clinical Events in Coronary Heart Disease Patients With an Ejection Fraction of 40% or Less: 3-Year Follow-up Results
Clinical Events in Coronary Heart Disease Patients With an Ejection Fraction of 40% or Less: 3-Year Follow-up Results
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临床%20事件%20in%20冠状动脉%20心脏%20疾病%20患者%20With%20an%20射血%20分数%20of%2040%%20或%20更少：%203年%20随访%20结果
DOI：
10.1097/jcn.0b013e3181d51f9e
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
G. Weidner
中科院分区：
文献类型：
--
作者：
C. Pischke;Melanie Elliott;Minmin Li;N. Mendell;D. Ornish;G. Weidner
背景与研究目的：目前尚不清楚生活方式的改变是否可以延迟无症状左心室射血分数（LVEF）降低的冠心病（CHD）患者的外科手术需求。这项初步研究的目的是检查生活方式的改变是否可以推迟这一人群对外科手术的需求。研究对象和方法：我们比较了27例适合接受血运重建的冠心病患者的3年临床事件（按保险标准），但经历了生活方式的改变（低脂饮食，锻炼，压力管理）（干预组[IG]，LVEF ≤40%），与历史匹配的（年龄、性别、LVEF和3条主要冠状动脉的狭窄）对照组接受常规护理（UCG; n = 13），在研究入组时接受血运重建。IG和UCG患者均入组参与多中心生活方式示范项目的健康保险公司，该项目是一项在美国8家医院开展的保险赞助的、基于社区的二级预防研究。结果与结论：3个月时，UCG组的心脏事件（6起事件）多于IG组（1起事件; P <0.006;比值比= 13.27;置信区间= 1.57-111.94）。这种差异持续了3年（P <0.06;比值比= 2.75;置信区间= 1.05-7.19）。在26例存活（1例心源性死亡）IG患者中，23例不需要初次血运重建。总之，无症状性LVEF降低的CHD患者通过改变生活方式可以安全地延迟血运重建，3年内心脏事件或明显心力衰竭的风险不会增加。
Background and Research Objective: It is unclear whether lifestyle changes can delay the need for surgical procedures in coronary heart disease (CHD) patients with asymptomatic reduced left ventricular ejection fraction (LVEF). The aim of this pilot study was to examine whether lifestyle changes can delay the need for surgical procedures in this population. Subjects and Methods: We compared 3-year clinical events in 27 CHD patients eligible to receive revascularization (by insurance standards), but underwent lifestyle changes (low-fat diet, exercise, stress management) instead (intervention group [IG], LVEF ≤40%), with those of a historically matched (age, gender, LVEF, and stenosis of the 3 major coronary arteries) control group receiving usual care (UCG; n = 13) who received revascularization at study entry. Both IG and UCG patients were enrolled in the health insurance companies participating in the Multicenter Lifestyle Demonstration Project, an insurance-sponsored, community-based, secondary prevention study implemented at 8 hospital sites in the United States. Results and Conclusion: At 3 months, there were more cardiac events in the UCG (6 events) than in the IG (1 event; P < .006; odds ratio = 13.27; confidence interval = 1.57-111.94). This difference was maintained over 3 years (P < .06; odds ratio = 2.75; confidence interval = 1.05-7.19). Of the 26 surviving (1 cardiac death) IG patients, 23 did not require primary revascularization. In conclusion, CHD patients with asymptomatic reduced LVEF may be able to safely delay revascularization by making changes in lifestyle with no increased risk for cardiac events or overt heart failure over 3 years.
影响因子：
37.8
作者：
HASKELL, WL;ALDERMAN, EL;FARQUHAR, JW
通讯作者：
FARQUHAR, JW
影响因子：
120.7
作者：
Flynn, Kathryn E.;Pina, Ileana L.;Whellan, David J.;Lin, Li;Blumenthal, James A.;Ellis, Stephen J.;Fine, Lawrence J.;Howlett, Jonathan G.;Keteyian, Steven J.;Kitzman, Dalane W.;Kraus, William E.;Miller, Nancy Houston;Schulman, Kevin A.;Spertus, John A.;O'Connor, Christopher M.;Weinfurt, Kevin P.
通讯作者：
Weinfurt, Kevin P.
影响因子：
120.7
作者：
O'Connor, Christopher M.;Whellan, David J.;Lee, Kerry L.;Keteyian, Steven J.;Cooper, Lawton S.;Ellis, Stephen J.;Leifer, Eric S.;Kraus, William E.;Kitzman, Dalane W.;Blumenthal, James A.;Rendall, David S.;Miller, Nancy Houston;Fleg, Jerome L.;Schulman, Kevin A.;McKelvie, Robert S.;Zannad, Faiez;Pina, Ileana L.
通讯作者：
Pina, Ileana L.