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Cardiac rehabilitation is associated with greater improvements in psychological health following coronary artery bypass graft surgery when compared to percutaneous coronary intervention.
Applied Physiology, Nutrition, and Metabolism ( IF 2.4 ) Pub Date : 2020-06-16 , DOI: 10.1139/apnm-2020-0213 Matthew Montesano 1, 2 , Jennifer L Reed 1, 3, 4 , Heather E Tulloch 3, 5 , Andrew L Pipe 3, 5 , Tasuku Terada 1
Applied Physiology, Nutrition, and Metabolism ( IF 2.4 ) Pub Date : 2020-06-16 , DOI: 10.1139/apnm-2020-0213 Matthew Montesano 1, 2 , Jennifer L Reed 1, 3, 4 , Heather E Tulloch 3, 5 , Andrew L Pipe 3, 5 , Tasuku Terada 1
Affiliation
Applied Physiology, Nutrition, and Metabolism, Ahead of Print.
Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (–0.4 ± 3.1 vs. –1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG. Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
中文翻译：
与经皮冠状动脉介入治疗相比，心脏康复与冠状动脉搭桥手术后心理健康的更大改善有关。
应用生理学、营养学和代谢，提前出版。
冠状动脉血运重建后，与接受经皮冠状动脉介入治疗 (PCI) 的患者相比，接受冠状动脉旁路移植术 (CABG) 治疗的患者发生主要不良心血管事件的风险较低。我们比较了在 CABG 和 PCI 后完成心脏康复 (CR) 的患者中心血管危险因素的变化，例如心理和心脏代谢健康指标。分析了 278 名在 CABG 或 PCI 后完成门诊 CR 计划的患者的纵向记录。我们比较了医院焦虑和抑郁量表 (HADS) 评估的焦虑和抑郁的变化；由医疗结果研究简表 36 (SF-36) 衡量的健康相关生活质量 (HR-QoL)；和心脏代谢健康指标（即体重、血压、血糖、和脂质谱）在 CABG 和 PCI 组之间使用协方差分析（ANCOVA）。在基线时，接受 PCI 治疗的患者 (n = 191) 具有优越的身体机能（即，身体机能：62.5 ± 22.1 vs. 54.3 ± 23.0 分，p = 0.006；以及由于身体健康导致的角色限制：31.2 ± 36.8 vs. 20.6 ± 31.8 分，p = 0.024）与 CABG 治疗的患者（n = 87）相比。CR 后，接受 PCI 治疗的患者在抑郁（–0.4 ± 3.1 与 –1.3 ± 2.7 分，p = 0.036）和精神 HR-QoL（精神成分总结：2.4 ± 10.8 与 5.7 ± 10.7 分， p = 0.020) 与接受 CABG 治疗的患者相比。新奇 与在 CR 入组时接受 CABG 治疗的患者相比，接受 PCI 治疗的冠状动脉疾病患者的功能限制较小，但心理健康状况相似。
更新日期：2020-06-16
Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (–0.4 ± 3.1 vs. –1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG. Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
中文翻译：
与经皮冠状动脉介入治疗相比，心脏康复与冠状动脉搭桥手术后心理健康的更大改善有关。
应用生理学、营养学和代谢，提前出版。
冠状动脉血运重建后，与接受经皮冠状动脉介入治疗 (PCI) 的患者相比，接受冠状动脉旁路移植术 (CABG) 治疗的患者发生主要不良心血管事件的风险较低。我们比较了在 CABG 和 PCI 后完成心脏康复 (CR) 的患者中心血管危险因素的变化，例如心理和心脏代谢健康指标。分析了 278 名在 CABG 或 PCI 后完成门诊 CR 计划的患者的纵向记录。我们比较了医院焦虑和抑郁量表 (HADS) 评估的焦虑和抑郁的变化；由医疗结果研究简表 36 (SF-36) 衡量的健康相关生活质量 (HR-QoL)；和心脏代谢健康指标（即体重、血压、血糖、和脂质谱）在 CABG 和 PCI 组之间使用协方差分析（ANCOVA）。在基线时，接受 PCI 治疗的患者 (n = 191) 具有优越的身体机能（即，身体机能：62.5 ± 22.1 vs. 54.3 ± 23.0 分，p = 0.006；以及由于身体健康导致的角色限制：31.2 ± 36.8 vs. 20.6 ± 31.8 分，p = 0.024）与 CABG 治疗的患者（n = 87）相比。CR 后，接受 PCI 治疗的患者在抑郁（–0.4 ± 3.1 与 –1.3 ± 2.7 分，p = 0.036）和精神 HR-QoL（精神成分总结：2.4 ± 10.8 与 5.7 ± 10.7 分， p = 0.020) 与接受 CABG 治疗的患者相比。新奇 与在 CR 入组时接受 CABG 治疗的患者相比，接受 PCI 治疗的冠状动脉疾病患者的功能限制较小，但心理健康状况相似。
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