Effects of the Strong Hearts program after a major cardiovascular event in patients with cardiovascular disease.

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL
Bruce E Murphy, Peyton D Card, Leybi Ramirez-Kelly, Amanda M Xaysuda, R Eric Heidel
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引用次数: 0

Abstract

Context: Cardiac rehabilitation (CR) and intensive cardiac rehabilitation (ICR) are secondary prevention interventions for cardiovascular disease (CVD) with a class 1a indication yet suboptimal utilization. To date, there are only three approved ICR programs. Alternative programing should be explored to increase enrollment and adherence in these interventions.

Objectives: This study aims to evaluate the effectiveness of the Strong Hearts program in cardiovascular patients following a major cardiovascular event.

Methods: One hundred ninety-seven (n = 197) participants were enrolled in this prospective, nonrandomized study. Patients were eligible for participation if they were referred by a physician after a major cardiovascular event, defined as any of the following: (1) acute myocardial infarction (MI) within the preceding 12 months; (2) current stable or unstable angina pectoris; (3) heart valve procedure; (4) percutaneous intervention of any kind; (5) heart transplant; (6) coronary artery bypass grafting (CABG); or (7) congestive heart failure (CHF) with reduced or preserved ejection fraction. Participants were asked to attend program visits four times per week for 9 weeks. Visits consisted of individualized exercise and intensive healthy lifestyle education. Paired t tests were utilized to compare pre- and postprogram outcome measures.

Results: One hundred twenty-eight (n = 128) participants completed the program within the 9-week time frame and their outcome measures were included in the data analysis. Among this, 35.2% participants were female and 64.8% were male. The mean age was 65 (range, 19-88). Qualifying diagnoses were percutaneous coronary intervention (PCI; 60, 46.9%), CABG (33, 25.8%), angina (24, 18.8%), valve procedures (8, 6.2%), and CHF (3, 2.3%). After implementation of the intervention, statistically significant decreases in weight (P < .001), body mass index (BMI, P < .001), waist circumference (P < .001), triglycerides (P = .01), systolic blood pressure (SBP, P <.001), diastolic blood pressure (DBP, P = .002), total fat mass (P < .001), Dartmouth Quality of Life Index P < .001), and cardiac depression scores (P = .044) were detected. In other instances, there were statistically significant increases across time for the clinical parameters of high-density lipoprotein (HDL, P = .02), Vitamin D (P = .001), metabolic equivalents (METS, P < .001), Duke activity scores (P < .001), and Rate Your Plate nutrition scores (P < .001). There were no significant changes across time for total cholesterol (P = .17), low-density lipoprotein (LDL, P = .21), A1c (P = .27), or dual-energy X-ray absorptiometry (DXA) total lean mass (P = .86).

Conclusions: The 9-week structured program resulted in significant cardiovascular benefit to patients with CVD by reducing cardiac risk factors, increasing exercise capacity, and improving quality of life.

心血管疾病患者发生重大心血管事件后强心计划的效果。
背景:心脏康复(CR)和强化心脏康复(ICR)是心血管疾病(CVD)的二级预防干预措施,具有1a级适应症,但利用率不理想。到目前为止,只有三个批准的ICR项目。应探索其他方案,以增加这些干预措施的入组率和依从性。目的:本研究旨在评估强心项目在重大心血管事件后心血管患者中的有效性。方法:197名(n = 197)参与者被纳入这项前瞻性、非随机研究。如果患者在发生重大心血管事件(定义为以下任何一种)后由医生转诊,则有资格参加研究:(1)在过去12个月内出现急性心肌梗死(MI);(2)目前有稳定或不稳定型心绞痛;(3)心脏瓣膜手术;(四)任何形式的经皮介入治疗;(5)心脏移植;(6)冠状动脉旁路移植术;或(7)充血性心力衰竭(CHF)伴射血分数降低或保留。参与者被要求在9周内每周参加4次项目访问。访问包括个体化锻炼和强化健康生活方式教育。配对t检验用于比较计划前后的结果测量。结果:128名(n = 128)参与者在9周的时间框架内完成了该计划,他们的结果测量被纳入数据分析。其中女性占35.2%,男性占64.8%。平均年龄65岁(范围19-88岁)。合格诊断为经皮冠状动脉介入治疗(PCI);60, 46.9%), CABG(33, 25.8%),心绞痛(24,18.8%),瓣膜手术(8,6.2%)和CHF(3, 2.3%)。实施干预后,体重(P < 0.001)、体重指数(BMI, P < 0.001)、腰围(P < 0.001)、甘油三酯(P = 0.01)、收缩压(SBP, P)的降低具有统计学意义。结论:9周的结构化方案通过减少心脏危险因素、增加运动能力和改善生活质量,对心血管疾病患者有显著的心血管益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Osteopathic Medicine
Journal of Osteopathic Medicine Health Professions-Complementary and Manual Therapy
CiteScore
2.20
自引率
13.30%
发文量
118
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