Krittanawong Chayakrit, Tweet Marysia S, Hayes Sarah E, Bowman Melissa J, Gulati Rajiv, Squires Ray W, Hayes Sharonne N
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Am J Cardiol. 2016 May 15;117(10):1604-1609. doi: 10.1016/j.amjcard.2016.02.034. Epub 2016 Mar 2.
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction; however, the role of cardiac rehabilitation (CR) for patients with SCAD has not been well defined. To further understand CR in patients with SCAD, we studied a large cohort of patients with confirmed SCAD enrolled in the Mayo Clinic SCAD Registry from January 2010 to December 2014 (n = 354). Demographics, clinical characteristics, mental health status, and details about CR participation and experience were collected through medical record review and questionnaires. Participants at time of SCAD were 46 ± 10 years old; 96% were women. Most (76%) attended ≥1 CR sessions, averaging 18 ± 12 sessions. Most reported CR-related physical and emotional benefits (82% and 75%, respectively). Of the CR nonparticipants, 57 of 85 reported not participating because CR was not recommended by their health care provider. Other reasons included inadequate transportation (10 of 85), no insurance coverage (7 of 85), cost (2 of 85), no energy (2 of 85), being too ill (2 of 85), and miscellaneous comments (5 of 85). In conclusion, 3 of 4 of patients with SCAD participated in CR, most of whom reported benefit. Lack of recommendation for CR by a health care provider was the primary reason patients did not participate.
自发性冠状动脉夹层(SCAD)是心肌梗死越来越常见的病因;然而,心脏康复(CR)对SCAD患者的作用尚未明确界定。为了进一步了解SCAD患者的心脏康复情况,我们研究了一大群确诊为SCAD的患者,这些患者于2010年1月至2014年12月被纳入梅奥诊所SCAD登记处(n = 354)。通过病历审查和问卷调查收集了人口统计学、临床特征、心理健康状况以及关于心脏康复参与情况和体验的详细信息。SCAD发作时参与者的年龄为46±10岁;96%为女性。大多数(76%)参加了≥1次心脏康复课程,平均为18±12次。大多数人报告了与心脏康复相关的身体和情绪益处(分别为82%和75%)。在未参加心脏康复的参与者中,85人中有57人报告未参加是因为他们的医疗保健提供者未推荐心脏康复。其他原因包括交通不便(85人中有10人)、没有保险覆盖(85人中有7人)、费用(85人中有2人)、没有精力(85人中有2人)、病情太重(85人中有2人)以及其他评论(85人中有5人)。总之,四分之三的SCAD患者参加了心脏康复,其中大多数人报告有获益。医疗保健提供者未推荐心脏康复是患者未参加的主要原因。