Exercise-based cardiac rehabilitation vs. percutaneous coronary intervention for chronic coronary syndrome: impact on morbidity and mortality
| Autor: | Benjamin J R Buckley, Paula Underhill, Elnara Fazio-Eynullayeva, Stephanie L Harrison, Iris A de Koning, Gregory Y.H. Lip, Hareld M. C. Kemps, Dick H. J. Thijssen |
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| Přispěvatelé: | Eindhoven MedTech Innovation Center, Future Everyday |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Epidemiology medicine.medical_treatment Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Myocardial Infarction Cardiac rehabilitation Chronic coronary syndrome Percutaneous coronary intervention RC1200 Angina Internal medicine Myocardial Infarction/epidemiology Medicine Humans Myocardial infarction cardiovascular diseases Stroke Exercise Percutaneous Coronary Intervention/adverse effects Retrospective Studies Heart Failure business.industry Incidence Secondary prevention Retrospective cohort study medicine.disease Treatment Outcome Cardiac Rehabilitation/adverse effects Heart Failure/complications Heart failure Conventional PCI Cohort Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Preventive Cardiology, 29, 7, pp. 1074-1080 Buckley, B J R, de Koning, I A, Harrison, S L, Fazio-Eynullayeva, E, Underhill, P, Kemps, H M C, Lip, G Y H & Thijssen, D H J 2022, ' Exercise-based cardiac rehabilitation vs. percutaneous coronary intervention for chronic coronary syndrome : impact on morbidity and mortality ', European Journal of Preventive Cardiology, vol. 29, no. 7, zwab191, pp. 1074–1080 . https://doi.org/10.1093/eurjpc/zwab191 EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY European Journal of Preventive Cardiology, 29, 1074-1080 European Journal of Preventive Cardiology, 29(7), 1074-1080. SAGE Publications Ltd |
| ISSN: | 2047-4873 2047-4881 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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