Pieters Kimberley, Utens Elisabeth M W J, Ter Hoeve Nienke, van Geffen Myrna, Dulfer Karolijn, Sunamura Madoka, van Domburg Ron T
Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Int J Cardiol. 2017 Mar 1;230:659-662. doi: 10.1016/j.ijcard.2017.01.006. Epub 2017 Jan 4.
Cardiac rehabilitation (CR) is recommended as secondary prevention in primary percutaneous coronary intervention (pPCI) patients. This study was conducted to expand the knowledge about age-effects of CR in pPCI patients. The aim of this study was to compare changes in subjective health status (SHS) during and after CR between patients <60years and patients ≥60years, who underwent pPCI after myocardial infarction.
Between 2009 and 2011, in total 282 pPCI patients who participated in CR were included. Patients completed the Short Form 12 (SF-12) questionnaire at baseline (pre-CR), 3months (post-CR) and 12months follow-up. Patients were divided into two age-groups, <60years versus ≥60years. To compare improvements in SHS between groups, Generalized Estimating Equations (GEE) analyses were performed.
The mean physical component summary (PCS) score improved over time in both groups and even reached mean levels of the normative Dutch population. The improvement on the PCS score was equal in both age groups. The mental component summary (MCS) score also improved in both groups. Patients <60years reported on average more improvement on the MCS score than patients ≥60years (Exp(B) 1.019; 95%CI 1.009-1.030; P<0.001). However, mean levels of the normative Dutch population were not reached by patients <60years.
Even though pPCI patients <60years reported more improvement on the MCS score, mean levels of the normative Dutch population were not reached. Therefore, a tailored CR program with more focus on their mental status, may be beneficial in younger patients.
心脏康复（CR）被推荐用于接受直接经皮冠状动脉介入治疗（pPCI）患者的二级预防。本研究旨在扩展对pPCI患者CR年龄效应的认识。本研究的目的是比较年龄<60岁和年龄≥60岁的心肌梗死后接受pPCI患者在CR期间及之后主观健康状况（SHS）的变化。
2009年至2011年，共纳入282例参与CR的pPCI患者。患者在基线（CR前）、3个月（CR后）和12个月随访时完成简短健康调查问卷（SF-12）。患者被分为两个年龄组，<60岁组与≥60岁组。为比较两组间SHS的改善情况，进行了广义估计方程（GEE）分析。
两组的平均生理健康评分（PCS）随时间均有改善，甚至达到荷兰正常人群的平均水平。两个年龄组在PCS评分上的改善程度相同。两组的心理健康评分（MCS）也都有所改善。年龄<60岁的患者报告MCS评分的平均改善程度高于年龄≥60岁的患者（Exp(B) 1.019；95%CI 1.009 - 1.030；P<0.001）。然而，年龄<60岁的患者未达到荷兰正常人群的平均水平。
尽管年龄<60岁的pPCI患者报告MCS评分改善更多，但未达到荷兰正常人群的平均水平。因此，针对年轻患者制定更关注其心理状态的CR方案可能有益。
