心肺康复护理在冠心病患者中应用的研究进展

Q: What are the key findings of this study?

Closed-loop cardiopulmonary rehabilitation nursing reduced 12-month rehospitalization and major adverse cardiac events by 64% in CHD patients.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Coronary heart disease (冠心病) (n=440). Intervention: Closed-loop cardiopulmonary rehabilitation nursing pathway (integrating multidisciplinary collaboration, individualized exercise prescription, smart wearable monitoring, and remote follow-up) vs. Routine nursing care. Primary outcome: 12-month rehospitalization rate (p=0.007).

红 马

doi:10.37155/2717-5669-0705-14

January 1, 2026国际全科医学Open Access

心肺康复护理在冠心病患者中应用的研究进展

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Key result

Closed-loop cardiopulmonary rehab nursing yields ~9 percentage points fewer 12-month rehospitalizations in CHD patients.

P=0.007
n=440

Why the study?

Does a closed-loop cardiopulmonary rehabilitation nursing pathway combining multidisciplinary collaboration and smart wearable monitoring reduce cumulative readmission rates and adverse cardiovascular events in patients with coronary heart disease?

Key Points

To evaluate the impact of a closed-loop cardiopulmonary rehabilitation pathway on readmission rates, cardiopulmonary function, neuroendocrine status, exercise compliance, and adverse events in patients with coronary heart disease.
Prospective cohort study of 440 matched coronary heart disease patients divided into an observation group and a control group (N=220 each).
Observation group received a 12-month closed-loop pathway integrating multidisciplinary collaboration, personalized exercise prescriptions, smart wearable monitoring, and remote follow-up, while the control group received standard care.
Observation group showed lower cumulative 12-month readmission rates than controls (15.91% [35/220] vs. 25.00% [55/220] at 12 months; total readmission events 43.18% [95/220] vs. 74.09% [163/220], P < 0.001).
From baseline to week 12, 6-minute walk distance increased by 100±20 m in the observation group versus 40±15 m in controls, while plasma BNP decreased by -100±10 pg/mL versus -50±8 pg/mL (both P < 0.001).
Key adverse events were reduced overall in the observation group compared to controls (7.27% vs. 20.45%; RR 0.36, 95% CI 0.21–0.61, P < 0.001), including heart failure (2.27% vs. 6.82%), arrhythmia (3.64% vs. 9.09%), and reinfarction (1.36% vs. 4.55%).

Study Design

Type

RCT (n=440)

Blinding

Open-label (outcome data verified by two blinded research assistants)

Randomization

Matched by age, sex, NYHA class, and baseline cardiac function, then randomly divided 1:1

Multicenter

No

Structured PICO

Does a closed-loop cardiopulmonary rehabilitation nursing pathway combining multidisciplinary collaboration and smart wearable monitoring reduce cumulative readmission rates and adverse cardiovascular events in patients with coronary heart disease?

P

Population

440 adults (aged 45-75 years, mean 58.3) with confirmed coronary heart disease (NYHA class I-III, LVEF ≥ 40%, free of persistent arrhythmia or prior acute MI) followed for 12 months.

I

Intervention

Closed-loop cardiopulmonary rehabilitation nursing pathway based on the 'Chinese Guidelines for Cardiac Rehabilitation and Secondary Prevention' ('assessment-intervention-monitoring-feedback') for 12 months, including multidisciplinary team (cardiologist, rehabilitation therapist, specialist nurse, nutritionist, psychologist) biweekly case discussions, individualized aerobic and resistance exercise prescriptions (3-5 times/week, 20-40 min/session at 60%-75% maximum heart rate), dedicated APP with daily reminders, monthly remote follow-ups, and continuous smart wearable device monitoring (heart rate strap, activity tracker) added to standard medical therapy.

C

Comparator

Routine nursing care for 12 months, including standardized health education manual at discharge, basic medication guidance, and outpatient follow-up every 3 months (symptom inquiry, medication adherence check, blood pressure and heart rate monitoring) without structured exercise prescriptions, multidisciplinary team involvement, remote follow-up, or wearable devices; both groups received consistent background disease management and pharmacotherapy (antiplatelets, statins, beta-blockers, ACEi/ARB).

O

Outcome

Cumulative readmission rate over 12 months (tracked at 3, 6, 9, and 12 months using Kaplan-Meier analysis and verified by two blinded research assistants)hard clinical

Main Result

Absolute Event Rate: 15.91% vs 25%

p-value: p=0.007

A 12-month closed-loop cardiopulmonary rehabilitation nursing pathway integrating multidisciplinary care and smart wearable monitoring significantly reduced hospital readmissions and major adverse cardiovascular events by 64% while improving 6-minute walk distance and lowering BNP levels in patients with coronary heart disease.

Limitations

Single-center study design
Lack of blinding
Insufficient depth of psychological intervention
11.8% loss to follow-up rate potentially introducing bias
Single-center design (单中心设计)
Unblinded (未设盲)
Insufficient depth of psychological intervention (心理干预深度亦存在不足)
11.8% loss to follow-up rate which may introduce bias (11.8%的失访率可能对结果产生一定偏倚)

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Implication

Closed-loop rehabilitation was associated with fewer rehospitalizations and MACE in CHD; hypothesis-generating and requires RCTs before practice change.

Abstract

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Discussion

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Cite This Study

红马 (2026) conducted an RCT in Coronary heart disease (冠心病) (n=440). Closed-loop cardiopulmonary rehabilitation nursing pathway (integrating multidisciplinary collaboration, individualized exercise prescription, smart wearable monitoring, and remote follow-up) vs. Routine nursing care was evaluated on 12-month rehospitalization rate (p=0.007). Closed-loop cardiopulmonary rehabilitation nursing reduced 12-month rehospitalization and major adverse cardiac events by 64% in CHD patients.

synapsesocial.com/papers/6af355015b67d29976ea0825 https://doi.org/10.37155/2717-5669-0705-14

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心肺康复护理在冠心病患者中应用的研究进展

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

心肺康复护理在冠心病患者中应用的研究进展

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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