Department of Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY; and.
Basic, Preventive and Clinical Sciences Department., Transilvania University, Brasov, Romania.
Am J Ther. 2023;30(4):e321-e325. doi: 10.1097/MJT.0000000000001640.
Complete bed rest has been a component of the management of acute myocardial infarction, which was first diagnosed in the United States in 1912. The prescribed duration of bed rest has been progressively shortened in the past century.
What are the milestones of the changes in the expert approach to the duration of bed rest for patients with acute myocardial infarction?
To determine the changes in the experts' approach to the duration of bed rest after a diagnosis of acute myocardial infarction, as presented in a widely used textbook in the United States.
The chapters presenting the management of myocardial infarction in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020.
Complete rest for 2-6 weeks was recommended by the Cecil's experts from 1927 through 1967. The practice was questioned since the early 1950s, but the recommended duration of bed rest was decreased to 3-4 days only in 1971, after most US hospitals opened coronary care units. The required time in bed was further decreased to 1 day in 1992 and to 12 hours in 2004. By 2007, the literature contained data from 15 trials with a total of 1471 patients kept in bed "longer" and 1487 patients who had been prescribed bed rest for "shorter" periods after an acute uncomplicate myocardial infarction and there was no difference between the groups regarding reinfarction, cardiac mortality, or all-cause mortality.
The duration of bed rest after acute myocardial infarction recommended by experts in the United States has had a downward trend with an inflection point in the early 1970s. The change reflected experts' opinion, rather than evidence produced by randomized controlled trials.
完全卧床休息一直是急性心肌梗死治疗的一个组成部分，这种治疗方法于 1912 年在美国首次被诊断出来。在过去的一个世纪里，卧床休息的规定时间逐渐缩短。
专家对急性心肌梗死患者卧床休息时间的处理方法有哪些变化的里程碑？
为了确定美国一本广泛使用的教科书中，专家在诊断急性心肌梗死后对卧床休息时间的处理方法的变化。
1927 年至 2020 年期间，Cecil 内科学教科书的 26 个版本中呈现的心肌梗死管理章节。
1927 年至 1967 年，Cecil 的专家建议完全卧床休息 2-6 周。自 20 世纪 50 年代初以来，这种做法就受到了质疑，但直到 1971 年，大多数美国医院开设了冠心病监护病房后，卧床休息的建议时间才缩短至 3-4 天。卧床时间进一步减少到 1992 年的 1 天和 2004 年的 12 小时。到 2007 年，文献中包含了 15 项试验的数据，这些试验共有 1471 名患者卧床时间“更长”，1487 名患者急性非复杂性心肌梗死后卧床休息时间“更短”，两组之间再梗死、心脏死亡率或全因死亡率没有差异。
美国专家推荐的急性心肌梗死后卧床休息时间呈下降趋势，20 世纪 70 年代初出现拐点。这种变化反映了专家的意见，而不是随机对照试验产生的证据。
