Al Najem Sinann, Groll Andreas, Schmermund Axel, Nowak Bernd, Voigtländer Thomas, Kaltenbach Ulrike, Dohmann Peter, Andresen Dietrich, Scharhag Jürgen
German Heart Foundation, Frankfurt, Germany.
Institute of Sports and Preventive Medicine, Saarbrücken, Germany.
Clin Med Insights Cardiol. 2022 Aug 24;16:11795468221116841. doi: 10.1177/11795468221116841. eCollection 2022.
Reducing risk by improving fitness is one of the main objectives of cardiac rehabilitation (CR). To estimate how the number of steps/day post-CR affects coronary patients' prognosis, we analyzed its correlation with the occurrence of death, hospitalizations, and heart complaints, and if and how other variables (ejection fraction (EF), gender, age) relate to those.
One hundred eleven patients (male = 91, female = 20; average age ± standard deviation (SD): 61 ± 11 years) who had been in CR due to recent coronary revascularization or chronic coronary syndrome could be enrolled. Patients were advised to document their steps (daily), blood pressure (daily), weight (weekly) and occurrences of a cardiac event in a diary for 1 year post-CR. A Cox proportional hazard model was used to examine the influence of steps/day, EF, gender, and age until the occurrence of an event. Kaplan-Meier curves were generated to compare patients' profiles.
Average steps/day of patients post-CR were 7333 (SD 4426). Increased walking activity reduced risk for cardiac hospitalization (constant steps/day: 5000 vs 7500, hazard rate (HR) reduction of 0.43; 10 000 vs 12 500, HR reduction of 0.20) and risk was higher in patients with an EF < 55% versus EF ⩾ 55% (HR increase of 2.88). Median follow-up time post-CR was 218 days. No patient died, 25 were hospitalized.
Monitoring the number of steps of coronary patients post CR could be valuable for estimating patients' prognosis.
通过改善体能来降低风险是心脏康复（CR）的主要目标之一。为了评估CR后每日步数如何影响冠心病患者的预后，我们分析了其与死亡、住院和心脏不适发生情况的相关性，以及其他变量（射血分数（EF）、性别、年龄）是否以及如何与这些情况相关。
纳入111例因近期冠状动脉血运重建或慢性冠状动脉综合征而接受CR的患者（男性91例，女性20例；平均年龄±标准差（SD）：61±11岁）。建议患者在CR后1年内，每天记录步数、血压、每周记录体重，并在日记中记录心脏事件的发生情况。使用Cox比例风险模型来检验每日步数、EF、性别和年龄对事件发生前的影响。绘制Kaplan-Meier曲线以比较患者的情况。
CR后患者的平均每日步数为7333步（SD 4426）。增加步行活动可降低心脏住院风险（每日恒定步数：5000步与7500步相比，风险率（HR）降低0.43；10000步与12500步相比，HR降低0.20），EF<55%的患者风险高于EF≥55%的患者（HR增加2.88）。CR后的中位随访时间为218天。无患者死亡，25例患者住院。
监测冠心病患者CR后的步数可能对评估患者预后有价值。
