Ul-Haq Zia, Khan Daud, Hisam Aliya, Yousafzai Yasar Mehmood, Hafeez Shazia, Zulfiqar Fatima, Gul Adnan Mahmood, Hafizullah Mohammad, Pell Jill
Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.
Department of Community Medicine, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
J Coll Physicians Surg Pak. 2019 Sep;29(9):803-809. doi: 10.29271/jcpsp.2019.09.803.
To find out the effectiveness of cardiac rehabilitation in patients with myocardial infarction in Pakistan.
Randomised controlled trial.
Cardiac Rehabilitation Unit, Lady Reading Hospital, Peshawar, Pakistan, from July to December 2016.
Patients suffering first myocardial infarction (MI) were randomly allocated to usual care or cardiac rehabilitation in a 1:1 ratio. Cardiac rehabilitation comprised two phases: 1-2 weeks during hospital stay followed by 6-7 weeks outpatient structured exercise programme. Two generic health related quality of life (HRQoL) outcomes (General Health Questionnaire (GHQ) and Self-Rated Health (SRH)) and one post-MI specific tool (MacNew QLMI) were measured at baseline and at 8 weeks follow-up among both groups. Lower SRH and GHQ scores and higher MacNew QLMI scores indicate better health status. Data were analysed using STATA 14.
Out of 206 participants, 195 (94.6%) were analysed at the end of trial. The mean age was 53 +8.3 years. In the cardiac rehabilitation group, the mean SRH score changed from 3.97 +0.9 at baseline to 2.36 +0.8 at follow-up (p<0.001). The mean GHQ of the cardiac rehabilitation group was 21.26 +5.5 at baseline and it decreased significantly to 7.43 +4.2 at follow-up (p<0.001). The MacNew QLMI of the cardiac rehabilitation group increased from 3.61 +1.07 to 5.62 +0.5 (p<0.001). The multivariate regression of all three HRQoL measures confirmed better HRQoL following cardiac rehabilitation compared with usual care (all p<0.001).
Cardiac rehabilitation following MI was effective in terms of improving HRQoL and can be implement in Pakistan as it produced significant improvements in HRQoL.
了解心脏康复对巴基斯坦心肌梗死患者的有效性。
随机对照试验。
2016年7月至12月，巴基斯坦白沙瓦市莱迪·里德医院心脏康复科。
首次发生心肌梗死（MI）的患者按1:1比例随机分配至常规护理组或心脏康复组。心脏康复包括两个阶段：住院期间1 - 2周，随后是6 - 7周的门诊结构化运动计划。在两组的基线和随访8周时，测量两个通用的健康相关生活质量（HRQoL）指标（一般健康问卷（GHQ）和自评健康（SRH））以及一个心肌梗死后专用工具（MacNew QLMI）。较低的SRH和GHQ评分以及较高的MacNew QLMI评分表明健康状况更好。使用STATA 14对数据进行分析。
206名参与者中，195名（94.6%）在试验结束时进行了分析。平均年龄为53±8.3岁。在心脏康复组中，平均SRH评分从基线时的3.97±0.9变为随访时的2.36±0.8（p<0.001）。心脏康复组的平均GHQ在基线时为21.26±5.5，随访时显著降至7.43±4.2（p<0.001）。心脏康复组的MacNew QLMI从3.61±1.07增加到5.62±0.5（p<0.001）。所有三个HRQoL指标的多变量回归证实，与常规护理相比，心脏康复后的HRQoL更好（所有p<0.001）。
心肌梗死后的心脏康复在改善HRQoL方面是有效的，并且由于其在HRQoL方面产生了显著改善，因此可以在巴基斯坦实施。
