Key result
Cardiac rehabilitation combining cardiopulmonary exercise testing with systematic education significantly improved Seattle Angina Questionnaire quality of life scores (68.69 vs 60.26, p<0.01) compared to routine education in ACS patients after PCI.
Why the study?
Real-world data on the long-term efficacy and safety of cardiopulmonary exercise testing combined with systematic cardiac rehabilitation education after coronary stenting were scarce.
Does CPET combined with systematic education of cardiac rehabilitation improve quality of life and physical activity in ACS patients post-PCI?
Cohort (n=5,610)
No
Does CPET combined with systematic education of cardiac rehabilitation improve quality of life and physical activity in ACS patients post-PCI?
Absolute Event Rate: 68.69% vs 60.26%
p-value: p=<0.01
A combined approach of CPET and systematic cardiac rehabilitation education significantly improves physical activity engagement and quality of life in ACS patients post-PCI without increasing adverse cardiovascular events.
May improve activity engagement and QoL post-PCI without excess MACE; leaves open need for RCTs to guide practice.
INTRODUCTION: There are scarce real-world data on the long-term efficacy and safety of cardiopulmonary exercise testing (CPET) combined with the systematic education of cardiac rehabilitation (CR) approach for patients post-coronary stenting, which is, therefore, the subject of this study. METHODS: Data collected between 1 April 2015 and 20 May 2017 from 11,345 patients in the rehabilitation center database at our hospital were retrospectively analyzed. Five hundred thirty-six patients with incomplete information, or unable to cooperate with telephone follow-up, were excluded; 4001 patients received the combined CR approach; and 6808 patients received only routine post-procedure education (controls). Of these, 2805 CR participants (CR group) were matched 1:1 to controls (control group) using propensity scores. The main outcome was quality of life in Seattle Angina Questionnaire (SAQ) scores. SAQ was measured in hospital and at follow-up; meanwhile, volume/type of habitual exercise, major adverse cardiovascular event (MACE), and its components of target vessel revascularization, myocardial infarction, and cardiac death were recorded and analyzed. RESULTS: At median 583 (range 184-963) day follow-up, compared with controls, the CR group showed fewer patients not engaging in physical exercise (22 vs. 956, p < 0.05); more cumulative exercise time (h/week) (8.22 ± 6.17 h vs. 3.00 ± 1.65 h, p < 0.05); higher SAQ scores (physical limitation, 69.59 ± 10.96 vs. 57.49 ± 7.19; anginal stability, 80.50 ± 18.21 vs. 58.82 ± 11.95; anginal frequency, 78.58 ± 11.07 vs. 67.14 ± 22.41; treatment satisfaction, 82.33 ± 13.21 vs. 56.84 ± 21.61; quality of life, 68.69 ± 18.33 vs. 60.26 ± 17.13, all p < 0.01), but a similar MACE rate (log-rank p = 0.621). CONCLUSION: Compared with only routine post-procedure education, CR combining at least one-time CPET with a systematic cardiac education program before discharge improved engagement in physical activity and quality of life for patients after percutaneous coronary intervention (PCI) without increasing clinical adverse events.
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Zhang et al. (2021) conducted a cohort in Acute Coronary Syndrome post-PCI (n=5,610). Cardiopulmonary exercise testing (CPET) combined with systematic education of cardiac rehabilitation vs. Routine post-procedure education was evaluated on Quality of life (Seattle Angina Questionnaire score) (p=<0.01). Cardiac rehabilitation combining cardiopulmonary exercise testing with systematic education significantly improved Seattle Angina Questionnaire quality of life scores (68.69 vs 60.26, p<0.01) compared to routine education in ACS patients after PCI.
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