Hedbäck B, Perk J
Eur Heart J. 1987 Mar;8(3):234-42. doi: 10.1093/oxfordjournals.eurheartj.a062265.
A comprehensive cardiac rehabilitation programme has been offered to a non-selected consecutive group of patients who have survived an acute myocardial infarction (MI). The programme includes follow-up at a post-MI clinic, physical training in outpatient groups, the provision of information on smoking and diet, and psychological support to patients and their families. The intervention group, consisting of the 147 patients participating in the programme has been compared with a nonselected consecutive reference group of 158 patients receiving standard care. During the five-year follow-up there was no difference in cardiac mortality between the groups, but the recurrence rate of non-fatal MI (17.3 vs 33.3%. P = 0.02) and the rate of total cardiac events was lower in the intervention group (39.5 vs 53.2%, P = 0.05). There was an alteration of risk factors, as there were fewer smokers and uncontrolled hypertensives in the intervention group. Patients in the reference group used more sedatives and long-acting nitroglycerine and had a lower return-to-work rate during the study period. The programme proved to be particularly effective in the age group below 55 years, where a significantly lower rate of total cardiac events was observed and more patients returned to work than in the reference group. It is concluded that the combined effect of the comprehensive programme has contributed to the long-term results, and that the programme offers an effective and safe method of secondary prevention after MI.
我们为一组未经挑选的急性心肌梗死（MI）存活患者提供了全面的心脏康复计划。该计划包括在心肌梗死后诊所进行随访、门诊小组的体育训练、提供有关吸烟和饮食的信息以及为患者及其家人提供心理支持。由147名参与该计划的患者组成的干预组与158名接受标准护理的未经挑选的连续参考组进行了比较。在五年的随访期间，两组之间的心脏死亡率没有差异，但干预组非致命性心肌梗死的复发率较低（17.3%对33.3%，P = 0.02），总心脏事件发生率也较低（39.5%对53.2%，P = 0.05）。危险因素发生了变化，干预组中吸烟者和未控制的高血压患者较少。参考组的患者在研究期间使用了更多的镇静剂和长效硝酸甘油，复工率较低。该计划在55岁以下年龄组中被证明特别有效，该组的总心脏事件发生率显著较低，且复工的患者比参考组更多。得出的结论是，综合计划的综合效果促成了长期结果，并且该计划为心肌梗死后的二级预防提供了一种有效且安全的方法。
