Cardiac rehabilitation in acute myocardial infarction patients after percutaneous coronary intervention

Abstract

Background:Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI).Methods:A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65). Cardiac function, a 6-minute walk distance, exercise time and steps, cardiovascular risk factors were monitored respectively and compared before and after the intervention of 2 groups. The software of EpiData 3.1 was used to input research data and SPSS16.0 was used for statistical analysis.Results:After a planned rehabilitation intervention, the rehabilitation group showed better results than the control group. The rehabilitation group had a significant improvement in recurrence angina and readmission (P < .01). Left ventricular ejection fraction (LVEF) of rehabilitation group showed improvement in phase II (t = 4.963, P < .01) and phase III (t = 11.802, P < .01), and the New York Heart Association (NYHA) classification was recovered within class II. There was a significant difference compared with before (Z = 7.238, P < .01). Six minutes walking distance, aerobic exercise time, and steps all achieved rehabilitation requirements in rehabilitation group in phase II and III, there existed distinct variation between 2 phases. Rehabilitation group had a better result in cardiovascular risk factors than control group (P < .05).Conclusion:Community-based CR after PCI through simple but safe exercise methods can improve the AMI patient's living quality, which includes increasing cardiac ejection fraction, exercise tolerance, and physical status. It must be emphasized that the good result should be established by the foundation of close cooperation between cardiologists and general practitioners, also the importance of cooperation of patients and their families should not be ignored. The rehabilitation program we used is feasible, safe, and effective.

Effects of Exercise to Improve Cardiovascular Health

“…Patients who underwent 60 min of exercise per day on a cycle ergometer for 4 weeks had an increase blood flow reserve (29%) and improved endothelium-dependent vasodilatation (10). A recent study provided personalized aerobic exercise rehabilitation programs for patients who had an acute myocardial infarction for 1 year after a coronary intervention surgery (92). The patients who underwent the exercise rehabilitation program had increased ejection fraction (60.81 vs. 53% control group), increased exercise tolerance, and reduced cardiovascular risk factors 6 months after starting the exercise rehabilitation program (92).…”

Transition of care to prevent recurrence after acute coronary syndrome: the critical role of the primary care provider and pharmacist

“…Real-world studies have indicated that community-based cardiac rehabilitation, including a collaboration between the primary care provider and cardiologist, improves the odds of achieving all therapeutic goals (i.e. medications, lifestyle, and risk factor control recommendations) [37] and leads to improvements in left ventricular ejection fraction, exercise tolerance, and cardiovascular risk factors [38]. When compared with hospital-based cardiac rehabilitation in a randomized trial, shared-care rehabilitation involving healthcare centers and primary care providers demonstrated similar effects on medication adherence and cardiovascular risk factors [39], as well as similar total healthcare-associated costs [40].…”

Modern strategies for cardiac rehabilitation after myocardial infarction and percutaneous coronary intervention

“…В исследовании Zhang Y. с соавт. индивидуальная программа физических тренировок у пациентов с ИМ, перенесших ЧКВ, контролировалась врачами общей практики и приводила к снижению проявлений сердечной недостаточности, уменьшению частоты постинфарктной стенокардии [34].…”