Effectiveness and Influencing Factors of Home-Center-Based Cardiac Rehabilitation as a Transitional Strategy for Acute Myocardial Infarction Patients

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS International heart journal Pub Date : 2024-07-13 DOI:10.1536/ihj.24-030
Xinyu Hou, Xiaojun Wu, Liangqi Chen, Xianghui Zheng, Yang Zheng, Yongxiang Zhang, Shiyu Wang, Tianhui Cao, Yong Sun, Rongjing Ding, Jian Wu, Bo Yu
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Abstract

Currently, providing patients, particularly those with acute myocardial infarction (AMI), with comprehensive cardiac rehabilitation (CR) has been challenging because of the inadequate availability of medical resources in developing countries. To ensure balance between disease instability and early rehabilitation, strategies for facilitating professional and comprehensive CR opportunities for patients with AMI must be explored.

A prospective cohort study was carried out on 1,533 patients with AMI who were admitted to a tertiary hospital between July 2018 and October 2019. Following the principle of voluntarism, 286 patients with AMI participated in home-center-based CR (HCB group), whereas 1,247 patients received usual care (UC group). The primary endpoint of this study was the occurrence of cardiovascular events at 30 months after AMI. Moreover, the study analyzed factors that influence participation rate and effectiveness of the CR model.

After analysis, a significant difference in the occurrence of cardiovascular endpoints between the HCB group and the UC group was observed (harzard ratio, 0.68 [95%CI, 0.51-0.91], P = 0.008), with participation in home-center-based CR being an independent influencing factor. Multivariate regression analysis revealed age, gender, smoking history, triglyceride levels, and ejection fraction as independent factors that influence participation rate. Female gender, peak oxygen uptake per kilogram body weight, and ventilation/carbon dioxide production slope were identified as factors that affect the effectiveness of the CR model.

In the context of developing countries, this study demonstrates that the home-center-based CR model is efficient and analyzes factors that influence participation rate and effectiveness of the model. These findings provide practical insights for further development of CR programs.

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以家庭为中心的心脏康复作为急性心肌梗死患者过渡策略的有效性和影响因素
目前,由于发展中国家的医疗资源不足,为患者,尤其是急性心肌梗死(AMI)患者提供全面的心脏康复(CR)一直是一项挑战。为确保疾病不稳定性与早期康复之间的平衡,必须探索为急性心肌梗死患者提供专业、全面的心脏康复机会的策略。一项前瞻性队列研究针对 2018 年 7 月至 2019 年 10 月期间入住一家三级医院的 1533 名急性心肌梗死患者展开。按照自愿原则,286 名 AMI 患者参加了以家庭为中心的 CR(HCB 组),而 1247 名患者接受了常规护理(UC 组)。这项研究的主要终点是急性心肌梗死后30个月内心血管事件的发生率。此外,该研究还分析了影响参与率和 CR 模式有效性的因素。经过分析,HCB 组和 UC 组之间的心血管终点发生率存在显著差异(哈扎德比值,0.68 [95%CI, 0.51-0.91],P = 0.008),参与家庭中心 CR 是一个独立的影响因素。多变量回归分析显示,年龄、性别、吸烟史、甘油三酯水平和射血分数是影响参与率的独立因素。女性性别、每公斤体重摄氧量峰值和通气/二氧化碳产生斜率被确定为影响 CR 模式有效性的因素。在发展中国家,本研究证明了基于家庭中心的 CR 模式是有效的,并分析了影响参与率和模式有效性的因素。这些研究结果为进一步发展 CR 项目提供了实用的见解。
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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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