Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes
Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes
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DOI：
10.1136/heartjnl-2017-311681
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发表时间：
2018-03-01
期刊：
影响因子：
5.7
通讯作者：
van Domburg, Ron T.
中科院分区：
文献类型：
--
作者：
Sunamura, Madoka;ter Hoeve, Nienke;van Domburg, Ron T.
目的对急性冠状动脉综合征（ACS）患者进行OPTICARE（OPTImal CAdiac REhistory）随机对照试验，比较两种先进和扩展的心脏康复（CR）方案与标准CR方案。这些方案旨在鼓励人们长期采用有利于心脏健康的生活方式。主要结局是评分（系统性冠状动脉风险评估）18个月随访时的10年心血管死亡风险函数。（年龄，57岁; 81%男性）被随机分为：（1）3个月标准CR（仅CR）;（2）标准CR，包括三个额外的面对面面对积极的生活方式辅导课程，并在首9个月内扩展为三个小组健身训练和一般生活方式辅导课程结果在意向性治疗分析中，我们发现CR + F组和单纯CR组在18个月时的SCORE风险函数无差异（3.30% vs 3.47%; p=0.48）或CR+T和仅CR（3.02% vs 3.47%; p=0.39）。在符合方案分析中，三个可修改的SCORE参数中有两个支持CR+F而非仅CR：目前吸烟（13.4% vs 21.3%; p
Objective The OPTICARE (OPTImal CArdiac REhabilitation) randomised controlled trial compared two advanced and extended cardiac rehabilitation (CR) programmes to standard CR for patients with acute coronary syndrome (ACS). These programmes were designed to stimulate permanent adoption of a heart-healthy lifestyle. The primary outcome was the SCORE (Systematic COronary Risk Evaluation) 10-year cardiovascular mortality risk function at 18 months follow-up.Methods In total, 914 patients with ACS (age, 57 years; 81% men) were randomised to: (1) 3 months standard CR (CR-only); (2) standard CR including three additional face-to-face active lifestyle counselling sessions and extended with three group fitness training and general lifestyle counselling sessions in the first 9 months after standard CR (CR+F); or (3) standard CR extended for 9 months with five to six telephone general lifestyle counselling sessions (CR+T).Results In an intention-to-treat analysis, we found no difference in the SCORE risk function at 18 months between CR+F and CR-only (3.30% vs 3.47%; p=0.48), or CR+T and CR-only (3.02% vs 3.47%; p=0.39). In a per-protocol analysis, two of three modifiable SCORE parameters favoured CR+F over CR-only: current smoking (13.4% vs 21.3%; p