Hou Wen-Hsuan, Lai Chien-Hung, Jeng Chii, Hsu Chuan-Chih, Shih Chun-Ming, Tsai Pei-Shan
Master Program in Long-Term Care and School of Gerontology and Health Management (Dr Hou), School of Nursing (Drs Jeng and Tsai), College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation (Drs Hou and Lai) and Sleep Science Center (Dr Tsai), Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation (Dr Lai), School of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Surgery (Dr Hsu), Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Surgery (Dr Hsu) and Department of Medicine (Dr Shih), School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine (Mr Shih), Department of Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
J Cardiopulm Rehabil Prev. 2016 Jul-Aug;36(4):250-7. doi: 10.1097/HCR.0000000000000168.
To evaluate the effects of cardiac rehabilitation (CR) provided within the first 3 months of revascularization on reducing recurrent revascularization in patients with coronary heart disease in Taiwan.
In this population-based cohort study, we used the claims data of 1 million beneficiaries who were randomly selected from all beneficiaries enrolled in Taiwan's National Health Insurance program from 1996 to 2000. Between 2000 and 2007, 2838 patients underwent a first-event revascularization. Of these patients, 442 (15.6%) underwent CR within the first 3 months of admission for revascularization. The remaining 84.4% (n = 2396) served as the non-CR group. All the study patients were followed-up until the end of 2008 for any recurrent revascularization. A propensity score-adjusted Cox proportional hazard model was used to estimate the relative risk of recurrent revascularization associated with CR.
During the 1- to 9-year follow-up, 69 patients (15.6%) in the CR group and 840 (35.1%) patients in the non-CR group experienced recurrent revascularization. The results of the propensity score-adjusted Cox proportional hazard regression analysis showed that CR was significantly associated with a reduced risk of recurrent revascularization with a hazard ratio of 0.48 (95% CI, 0.37 to -0.62).
Cardiac rehabilitation within the first 3 months of revascularization is significantly associated with a reduced risk of recurrent revascularization. This preventive effect was more pronounced in men compared with other subgroups of patients.
评估血运重建后前3个月内进行心脏康复（CR）对降低台湾冠心病患者再次血运重建发生率的效果。
在这项基于人群的队列研究中，我们使用了从1996年至2000年参加台湾全民健康保险计划的所有受益人中随机抽取的100万受益人的理赔数据。2000年至2007年期间，2838例患者接受了首次血运重建。在这些患者中，442例（15.6%）在血运重建入院后的前3个月内接受了CR。其余84.4%（n = 2396）作为非CR组。所有研究患者均随访至2008年底，观察是否发生再次血运重建。采用倾向评分调整的Cox比例风险模型来估计与CR相关的再次血运重建的相对风险。
在1至9年的随访期间，CR组有69例患者（15.6%）发生再次血运重建，非CR组有840例患者（35.1%）发生再次血运重建。倾向评分调整的Cox比例风险回归分析结果显示，CR与再次血运重建风险降低显著相关，风险比为0.48（95%CI，0.37至-0.62）。
血运重建后前3个月内进行心脏康复与再次血运重建风险降低显著相关。与其他患者亚组相比，这种预防效果在男性中更为明显。
