AIMS Accumulating evidence questions the clinical value of percutaneous coronary intervention (PCI) for patients with chronic coronary syndrome (CCS). We therefore compare the impact of exercise-based cardiac rehabilitation (CR) vs. PCI in patients with CCS on 18-month mortality and morbidity, and evaluate the effects of combining PCI with exercise-based CR. METHODS AND RESULTS A retrospective cohort study was conducted in March 2021. An online, real-world dataset of CCS patients was acquired, utilizing TriNetX, a global federated health research network. Patients with CCS who received PCI were first compared with patients who were prescribed exercise-based CR. Second, we compared patients who received both CR + PCI vs. CR alone. For both comparisons, patients were propensity-score matched by age, sex, race, comorbidities, medications, and procedures. We ascertained 18-month incidence of all-cause mortality, rehospitalization, and cardiovascular comorbidity [stroke, acute myocardial infarction (AMI), and new-onset heart failure]. The initial cohort consisted of 18 383 CCS patients. Following propensity score matching, exercise-based CR was associated with significantly lower odds of all-cause mortality [0.37 (95% confidence interval (CI): 0.29-0.47)], rehospitalization [0.29 (95% CI: 0.27-0.32)], and cardiovascular morbidities, compared to PCI. Subsequently, patients that received both CR + PCI did not have significantly different odds for all-cause mortality [1.00 (95% CI: 0.63-1.60)], rehospitalization [1.00 (95% CI: 0.82-1.23)], AMI [1.11 (95% CI: 0.68-1.81)], and stroke [0.71 (95% CI: 0.39-1.31)], compared to CR only. CONCLUSIONS Compared to PCI, exercise-based CR associated with significantly lower odds of 18-month all-cause mortality, rehospitalization, and cardiovascular morbidity in patients with CCS, whilst combining PCI and exercise-based CR associated with lower incident heart failure only.

中文翻译：

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基于运动的心脏康复与慢性冠状动脉综合征的经皮冠状动脉介入治疗：对发病率和死亡率的影响。

AIMS 越来越多的证据质疑经皮冠状动脉介入治疗 (PCI) 对慢性冠状动脉综合征 (CCS) 患者的临床价值。因此，我们比较了基于运动的心脏康复 (CR) 与 PCI 对 CCS 患者 18 个月死亡率和发病率的影响，并评估了将 PCI 与基于运动的 CR 相结合的效果。方法和结果 2021 年 3 月进行了一项回顾性队列研究。利用全球联合健康研究网络 TriNetX，获得了 CCS 患者的在线真实世界数据集。首先将接受 PCI 的 CCS 患者与接受基于运动的 CR 的患者进行比较。其次，我们比较了同时接受 CR + PCI 与单独 CR 的患者。对于这两项比较，患者的倾向评分与年龄、性别、种族、合并症、药物、和程序。我们确定了 18 个月内全因死亡率、再住院和心血管合并症 [中风、急性心肌梗死 (AMI) 和新发心力衰竭] 的发生率。最初的队列由 18 383 名 CCS 患者组成。在倾向得分匹配后，基于运动的 CR 与显着降低全因死亡率 [0.37（95% 置信区间（CI）：0.29-0.47）]、再住院率 [0.29（95% CI：0.27-0.32）] 的几率相关和心血管疾病，与 PCI 相比。随后，接受 CR + PCI 的患者的全因死亡率 [1.00 (95% CI: 0.63-1.60)]、再住院 [1.00 (95% CI: 0.82-1.23)]、AMI [1.11] 的几率没有显着差异(95% CI: 0.68-1.81)] 和中风 [0.71 (95% CI: 0.39-1.31)]，与仅 CR 相比。结论 与 PCI 相比，