Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan, ROC.
Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2021 Jun 1;84(6):596-605. doi: 10.1097/JCMA.0000000000000536.
Lifestyle modification is suggested for patients with coronary artery disease (CAD), but the impact of adherence to a healthy lifestyle remains undetermined. The aim of this study is to investigate the association of adherence to a healthy lifestyle with future outcomes and biochemical markers in CAD patients.
The Biosignature CAD study examined 716 CAD patients who underwent a percutaneous coronary intervention (PCI). Information was collected on whether these patients adhered to a healthier lifestyle after PCI, including healthy diet, not smoking, and exercise. The clinical outcomes included major cardiovascular events and unplanned revascularization procedures, hospitalization for refractory or unstable angina, and other causes.
The average follow-up period was 26.8 ± 8.1 months, during which 175 (24.4%) patients experienced at least one event. The combination of healthy lifestyle factors was associated with lower risk, and the maximum risk reduction reached 50% (hazard ratio: 0.50, 95% confidence interval: 0.25-0.99). As the number of healthy lifestyle factors increased, there were decreases in inflammatory markers, C-reactive protein, waist circumference, low-density lipoprotein cholesterol, and the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol (p < 0.05). The benefits of modifiable healthy lifestyle factors were especially observed in the younger population, males, patients with HDL <40 mg/dL, those with reduced left ventricular ejection fraction, and those receiving statin therapy.
Adherence to a healthy lifestyle is independently associated with a lower risk of future adverse events in CAD patients and plays an important role in secondary prevention in the era of interventional cardiology.
生活方式的改变被建议用于冠心病（CAD）患者，但坚持健康生活方式的影响仍未确定。本研究的目的是调查 CAD 患者坚持健康生活方式与未来结局和生化标志物的关系。
Biosignature CAD 研究检查了 716 例接受经皮冠状动脉介入治疗（PCI）的 CAD 患者。收集了这些患者在 PCI 后是否坚持更健康的生活方式的信息，包括健康饮食、不吸烟和运动。临床结局包括主要心血管事件和计划外血运重建、因难治性或不稳定型心绞痛住院以及其他原因住院。
平均随访时间为 26.8 ± 8.1 个月，期间 175 例（24.4%）患者至少发生了一次事件。健康生活方式因素的组合与较低的风险相关，最大风险降低达 50%（风险比：0.50，95%置信区间：0.25-0.99）。随着健康生活方式因素数量的增加，炎症标志物 C 反应蛋白、腰围、低密度脂蛋白胆固醇和总胆固醇与高密度脂蛋白（HDL）胆固醇的比值降低（p < 0.05）。可改变的健康生活方式因素的益处尤其在年轻患者、男性、HDL <40 mg/dL 的患者、左心室射血分数降低的患者和接受他汀类药物治疗的患者中观察到。
坚持健康的生活方式与 CAD 患者未来不良事件的风险降低独立相关，并在介入心脏病学时代对二级预防起着重要作用。
