Nishitani-Yokoyama Miho, Daida Hiroyuki, Shimada Kazunori, Ushijima Akiko, Kida Keisuke, Kono Yuji, Sakata Yasuhiko, Nagayama Masatoshi, Furukawa Yutaka, Fukuma Nagaharu, Saku Keijiro, Miura Shin-Ichiro, Ohya Yusuke, Goto Youichi, Makita Shigeru
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine Tokyo Japan.
Faculty of Health and Science Juntendo University Tokyo Japan.
Circ Rep. 2020 Nov 27;2(12):715-721. doi: 10.1253/circrep.CR-20-0087.
Cardiac rehabilitation (CR) is categorized as a Class I recommendation in guidelines for the management of patients with acute coronary syndrome (ACS); however, nationwide studies on CR in patients with ACS remain limited in Japan. The Japanese Association of Cardiac Rehabilitation (JACR) Registry is a nationwide, real-world database for patients participating in CR. From the JACR Registry database, we analyzed 924 patients participating in Phase II CR in 7 hospitals between September 2014 and December 2016. The mean age of patients was 65.9±12.0 years, and 80% were male. The prevalence of ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina pectoris (UAP) was 58%, 9%, and 33%, respectively. The prevalence of hypertension, diabetes, dyslipidemia, current smoking, and a family history was 55%, 27%, 67%, 21%, and 10%, respectively. Among the entire CR cohort at baseline, 96%, 78%, and 92% were treated with aspirin, β-blockers, and statins, respectively. After CR, the values of body mass index, the lipid profile, and exercise capacity significantly improved in the STEMI, NSTEMI and UAP groups. In the JACR Registry, a high rate of guideline-recommended medications at baseline and improvements in both coronary risk factors and exercise capacity after CR were observed in patients with ACS.
心脏康复（CR）在急性冠状动脉综合征（ACS）患者管理指南中被列为I类推荐；然而，在日本，关于ACS患者心脏康复的全国性研究仍然有限。日本心脏康复协会（JACR）登记处是一个针对参与心脏康复患者的全国性真实世界数据库。我们从JACR登记处数据库中分析了2014年9月至2016年12月期间在7家医院参与II期心脏康复的924例患者。患者的平均年龄为65.9±12.0岁，80%为男性。ST段抬高型心肌梗死（STEMI）、非ST段抬高型心肌梗死（NSTEMI）和不稳定型心绞痛（UAP）的患病率分别为58%、9%和33%。高血压、糖尿病、血脂异常、当前吸烟和家族史的患病率分别为55%、27%、67%、21%和10%。在基线时，整个心脏康复队列中分别有96%、78%和92%的患者接受了阿司匹林、β受体阻滞剂和他汀类药物治疗。心脏康复后，STEMI、NSTEMI和UAP组的体重指数、血脂谱和运动能力值均显著改善。在JACR登记处，观察到ACS患者在基线时指南推荐药物的使用率很高，并且心脏康复后冠状动脉危险因素和运动能力均有所改善。
