SMARTphone-based, early cardiac REHABilitation in patients with acute coronary syndromes: a randomized controlled trial

医学 临床终点 康复 随机对照试验 内科学 生活质量(医疗保健) 物理疗法 急性冠脉综合征 介绍 心脏病学 心肌梗塞 护理部 家庭医学
作者
M. Yudi,David Clark,David Tsang,Michael Jelinek,Katie Kalten,S. Joshi,Khoa Phan,Jay Ramchand,Arthur Nasis,John Amerena,A. Koshy,A. Murphy,Sandeep Arunothayaraj,Si Si,Christopher M. Reid,Omar Farouque
出处
期刊:Coronary Artery Disease [Lippincott Williams & Wilkins]
卷期号:32 (5): 432-440 被引量:63
标识
DOI:10.1097/mca.0000000000000938
摘要

There are well-documented treatment gaps in secondary prevention of coronary heart disease with a lack of clearly defined strategies to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps.The primary goal of this study was to assess whether a smartphone-based, early cardiac rehabilitation program improved exercise capacity in patients with ACS.A total of 206 patients with ACS across six tertiary Australian hospitals were included in this randomized controlled trial. Participants were randomized to usual care (UC; including referral to traditional cardiac rehabilitation), with or without an adjunctive smartphone-based cardiac rehabilitation program (S-CRP) upon hospital discharge. The primary endpoint was change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline, between groups. Secondary endpoints included uptake and adherence to cardiac rehabilitation, changes in cardiac risk factors, psychological well-being and quality of life status.Of the 168 patients with complete follow-up (age 56 ± 10 years; 16% females), 83 were in the S-CRP. At 8-week follow-up, the S-CRP group had a clinically significant improvement in 6-minute walk test distance (Δ117 ± 76 vs. Δ91 ± 110 m; P = 0.02). Patients in the S-CRP were more likely to participate (87% vs. 51%, P < 0.001) and adhere (72% vs. 22%, P < 0.001) to a cardiac rehabilitation program. Compared to UC, patients receiving S-CRP had similar smoking cessation rates, LDL-cholesterol levels, blood pressure reduction, depression, anxiety and quality of life measures (all P = NS).In patients with ACS, a S-CRP, as an adjunct to UC improved exercise capacity at 8 weeks in addition to participation and adherence to cardiac rehabilitation (Australian New Zealand Clinical Trials Registry; ACTRN12616000426482).
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