Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE High Blood Pressure & Cardiovascular Prevention Pub Date : 2024-03-01 Epub Date: 2024-04-02 DOI:10.1007/s40292-024-00636-2

Amir Vahedian-Azimi, Mohammad Javad Sanjari, Farshid Rahimi-Bashar, Keivan Gohari-Mogadam, Ayoub Ouahrani, Emad Mraweh Mohammed Mustafa, Ali Ait Hssain, Amirhossein Sahebkar

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Abstract

Introduction: Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack.

Aim: To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program.

Methods: This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL).

Results: The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group.

Conclusion: This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations.

Trial registration: This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.

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使用以家庭为中心的赋权模式进行心脏康复可有效改善心肌梗死患者的长期死亡率：一项为期 10 年的随访随机临床试验。

导言目的：评估心肌梗死（MI）幸存者在实施以家庭为中心的赋权模式（FCEM）为重点的混合心脏康复计划后的死亡率和效果稳定性：这项双盲随机对照临床试验在伊朗德黑兰的学术教学医院沙里亚蒂医院进行（2012-2023 年），共有 70 名心肌梗死患者及其家属参与。参与者被随机分配到 FCEM 干预组或标准 CR 对照组。干预在心肌梗死患者安全离开重症监护室后开始，并持续整个 10 年的随访期。采用各种问卷收集死亡率和健康相关生活质量（HRQoL）的数据：结果：10 年随访期显示，干预组的死亡率（5 年、7 年和 10 年分别为 5.7%、11.4% 和 17.1%）低于对照组（20%、37.1% 和 48.9%）。在对年龄、性别和体重指数进行调整后，对照组的死亡风险是对照组的四倍（HR：4.346，95% CI 1.671-7.307，P = 0.003）。与对照组相比，以 FCEM 为重点的项目对参与者的生活质量产生了长达 48 个月的显著且持续的积极影响，改善幅度更大：本研究强调了以 FCEM 为基础的混合 CR 项目在提高患者长期疗效和降低 MI 幸存者死亡率方面的有效性。需要进一步研究，以探索在更大样本和不同人群中的潜在益处：本研究（标识符：NCT02402582）于2015年3月30日在ClinicalTrials.gov注册。

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来源期刊

High Blood Pressure & Cardiovascular Prevention PERIPHERAL VASCULAR DISEASE-

CiteScore

5.70

自引率

3.30%

发文量

期刊介绍： High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes: Invited ''State of the Art'' reviews. Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.