Effectiveness and Safety of Remote Cardiac Rehabilitation for Patients After Acute Coronary Syndrome
Effectiveness and Safety of Remote Cardiac Rehabilitation for Patients After Acute Coronary Syndrome
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DOI：
10.1016/j.amjcard.2023.08.168
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发表时间：
2023-09-16
影响因子：
2.8
通讯作者：
Pereg，David
中科院分区：
文献类型：
--
作者：
Hilu，Ranin;Haskiah，Feras;Pereg，David
心脏康复改善急性冠脉综合征（ACS）患者的心血管结局。近年来，远程心脏康复（RCR）计划受到越来越多的关注。我们的目的是评价RCR与基于中心的心脏康复（CBCR）相比的有效性。这是一项观察性研究，包括因ACS住院的患者。研究组包括心血管并发症低至中度风险的患者，他们被转诊接受RCR。对照组包括参与CBCR的相似风险的患者。主要终点是心脏康复6个月后运动能力至少提高10%至25%。纳入了305名完成6个月心脏康复的患者。其中，107例患者参加了RCR，198例患者参加了CBCR。RCR患者更年轻，男性更常见。与CBCR相比，参加RCR的患者6个月后运动能力改善≥10%的频率更高（分别为69.3%和55%，p = 0.03）。6个月后观察到运动能力改善≥25%的相似趋势（RCR和CBCR分别为33.8%和22.7%，p = 0.05）。虽然两组的体重减轻和肌肉质量增加相似，但与CBCR相比，RCR的脂肪百分比减少显著更大（分别为2.5%和1.4%，p <0.005）。我们的结论是，RCR程序是一个有效和安全的选择低风险患者入院后的ACS。它可以优化冠状动脉疾病患者对这一重要服务的利用。
Cardiac rehabilitation improves cardiovascular outcomes in patients after acute coronary syndrome (ACS). Recently there has been a growing interest in remote cardiac rehabilitation (RCR) programs. We aimed to evaluate the effectiveness of RCR compared with center-based cardiac rehabilitation (CBCR). This is an observational study including patients after hospital admission for ACS. The study group included patients at low-to-moderate risk for cardiovascular complications who were referred for RCR. The control group included patients at similar risk who participated in CBCR. The primary end points were the improvement of at least 10% to 25% in exercise capacity after 6 months of cardiac rehabilitation. Included were 305 patients who completed 6 months of cardiac rehabilitation. Of them, 107 patients participated in RCR and 198 in CBCR. RCR patients were younger and more frequently males. Improvement of ≥10% in exercise capacity after 6 months was achieved more frequently in patients participating in RCR compared with CBCR (69.3% and 55% respectively, p = 0.03). A similar trend was observed for improvement of ≥25% in exercise capacity after 6 months (33.8% and 22.7% in RCR and CBCR, respectively, p = 0.05). While weight reduction and the increase in muscle mass were similar in the 2 groups, fat percent reduction was significantly greater in the RCR compared with the CBCR (2.5% and 1.4% respectively, p <0.005). We conclude that RCR program is an effective and safe option for low-risk patients after hospital admission for ACS. It enables optimizing the utilization of this important service for patients with coronary artery disease.