Iliuță Luminița, Andronesi Andreea Gabriella, Rac-Albu Marius, Rac-Albu Mădălina-Elena, Scafa-Udriște Alexandru, Moldovan Horațiu, Furtunescu Florentina Ligia, Rădulescu Bogdan Constantin, Panaitescu Eugenia
Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Cardioclass Clinic for Cardiovascular Disease, 031125 Bucharest, Romania.
Healthcare (Basel). 2023 May 29;11(11):1590. doi: 10.3390/healthcare11111590.
(1) Background: The COVID-19 pandemic has introduced a major disruption to the delivery of secondary prevention measures in patients with established atherosclerotic cardiovascular disease (CVD). It required a rapid and widespread adoption of new medical services, including the use of telemedicine. This study aimed to examine the impact of COVID-19 on secondary prevention in patients with coronary artery bypass grafting (CABG) and to evaluate the effectiveness of the telemedicine application for the implementation of lifestyle change measures, remote monitoring, and treatment regimen adjustment; (2) Methods: This prospective study on 194 CABG patients evaluated three consecutive years between 2019 and 2022 in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up. Variables of interest were compared between four periods: pre-pandemic-pre-P (1 March 2019-29 February 2020), lockdown-Lock (1 March-31 August 2020), restrictive-pandemic-Restr-P (1 September 2020-28 February 2021), and relaxed-pandemic-Rel-P (1 March 2021-1 March 2022). (3) Results: The average values of the lipidogram, blood sugar, and uric acid increased during Lock and Restr-P, but, through the use of teleprevention, they returned to the pre-pandemic level or even below this level. The exception was blood sugar, which remained high in Rel-P. The number of newly diagnosed patients with diabetes also increased, with most of them having moderate forms of COVID. During Lock and Res-P, the percentage of obese, smoking, or hypertensive patients increased, but, through the use of teleprevention, we managed to reduce it, although it remained slightly higher than the pre-pandemic level. Physical activity decreased in the first year of the pandemic, but, in Rel-P, CABG patients became more active than before the pandemic (4) Conclusions: The use of telemedicine for cardiovascular secondary prevention allowed us to not only continue seeing CABG patients but, also, to adjust their medication and to expand cardiovascular preventive counseling and testing with favorable results, especially during the second year of the pandemic.
（1）背景：新冠疫情对已确诊动脉粥样硬化性心血管疾病（CVD）患者二级预防措施的实施造成了重大干扰。这需要迅速且广泛地采用新的医疗服务，包括使用远程医疗。本研究旨在探讨新冠疫情对冠状动脉旁路移植术（CABG）患者二级预防的影响，并评估远程医疗应用于实施生活方式改变措施、远程监测和治疗方案调整的有效性；（2）方法：这项前瞻性研究对194例CABG患者进行了评估，在2019年至2022年连续三年的疫情前阶段通过面对面就诊，在疫情期间通过远程会诊或混合随访。对四个时期的感兴趣变量进行了比较：疫情前-P期（2019年3月1日至2020年2月29日）、封锁期-Lock（2020年3月1日至8月31日）、限制期-疫情-Restr-P（2020年9月1日至2021年2月28日）和宽松期-疫情-Rel-P（2021年3月1日至2022年3月1日）。（3）结果：血脂谱、血糖和尿酸的平均值在Lock期和Restr-P期有所升高，但通过远程预防，它们恢复到了疫情前水平甚至低于该水平。血糖是个例外，在Rel-P期仍居高不下。新诊断糖尿病患者的数量也有所增加，其中大多数患有中度新冠。在Lock期和Res-P期，肥胖、吸烟或高血压患者的比例有所增加，但通过使用远程预防，我们设法降低了该比例，尽管仍略高于疫情前水平。疫情第一年身体活动减少，但在Rel-P期，CABG患者比疫情前更加活跃。（4）结论：使用远程医疗进行心血管二级预防不仅使我们能够继续诊治CABG患者，还能调整他们的药物治疗，并扩大心血管预防咨询和检测，取得了良好效果，尤其是在疫情的第二年。
