Biersteker Tommas Evan, Boogers Mark J, Schalij Martin Jan, Braun Jerry, Groenwold Rolf H H, Atsma Douwe E, Treskes Roderick Willem
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Department of Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Eur Heart J Digit Health. 2023 Jun 7;4(4):347-356. doi: 10.1093/ehjdh/ztad035. eCollection 2023 Aug.
Lowering low-density lipoprotein (LDL-C) and blood pressure (BP) levels to guideline recommended values reduces the risk of major adverse cardiac events in patients who underwent coronary artery bypass grafting (CABG). To improve cardiovascular risk management, this study evaluated the effects of mobile health (mHealth) on BP and cholesterol levels in patients after standalone CABG.
This study is a analysis of an observational cohort study among 228 adult patients who underwent standalone CABG surgery at a tertiary care hospital in The Netherlands. A total of 117 patients received standard care, and 111 patients underwent an mHealth intervention. This consisted of frequent BP and weight monitoring with regimen adjustment in case of high BP. Primary outcome was difference in systolic BP and LDL-C between baseline and value after three months of follow-up. Mean age in the intervention group was 62.7 years, 98 (88.3%) patients were male. A total of 26 449 mHealth measurements were recorded. At three months, systolic BP decreased by 7.0 mmHg [standard deviation (SD): 15.1] in the intervention group vs. -0.3 mmHg (SD: 17.6; < 0.00001) in controls; body weight decreased by 1.76 kg (SD: 3.23) in the intervention group vs. -0.31 kg (SD: 2.55; = 0.002) in controls. Serum LDL-C was significantly lower in the intervention group vs. controls (median: 1.8 vs. 2.0 mmol/L; = 0.0002).
This study showed an association between home monitoring after CABG and a reduction in systolic BP, body weight, and serum LDL-C. The causality of the association between the observed weight loss and decreased LDL-C in intervention group patients remains to be investigated.
将低密度脂蛋白（LDL-C）和血压（BP）水平降至指南推荐值可降低接受冠状动脉旁路移植术（CABG）患者发生主要不良心脏事件的风险。为改善心血管风险管理，本研究评估了移动健康（mHealth）对单纯CABG术后患者血压和胆固醇水平的影响。
本研究是对荷兰一家三级护理医院228例接受单纯CABG手术的成年患者进行的观察性队列研究的分析。共有117例患者接受标准护理，111例患者接受mHealth干预。干预包括频繁监测血压和体重，若血压高则调整治疗方案。主要结局是随访三个月后收缩压和LDL-C的基线值与测量值之间的差异。干预组的平均年龄为62.7岁，98例（88.3%）患者为男性。共记录了26449次mHealth测量值。三个月时，干预组收缩压下降7.0 mmHg [标准差（SD）：15.1]，而对照组下降-0.3 mmHg（SD：17.6；P<0.00001）；干预组体重下降1.76 kg（SD：3.23），而对照组下降-0.31 kg（SD：2.55；P = 0.002）。干预组血清LDL-C显著低于对照组（中位数：1.8 vs. 2.0 mmol/L；P = 0.0002）。
本研究表明CABG术后家庭监测与收缩压、体重和血清LDL-C降低之间存在关联。干预组患者体重减轻与LDL-C降低之间关联的因果关系仍有待研究。
