Kleinnibbelink Geert, Buckley Benjamin J R, Harrison Stephanie L, Williams Nefyn, Fazio-Eynullayeva Elnara, Underhill Paula, van Dijk Arie P J, Lip Gregory Y H, Thijssen Dick H J
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Research Institute for Health Sciences, Departments of Physiology and Cardiology, Radboud University Medical Center, Nijmegen, Netherlands.
Front Sports Act Living. 2023 Dec 11;5:1247615. doi: 10.3389/fspor.2023.1247615. eCollection 2023.
Despite pharmacological therapies to improve outcomes of pulmonary hypertension (PH), poor long-term survival remains. Exercised-based cardiac rehabilitation (ExCR) may be an alternative strategy to improve prognosis. Therefore, using an electronic medical record (EMR) database, the objective of this study was to compare mortality between patients with primary PH with ExCR vs. propensity-matched PH patients without ExCR.
The retrospective analysis was conducted on February 15, 2023 using anonymized data within TriNetX, a global federated health research network. All patients were aged ≥18 years with primary PH recorded in EMRs with at least 1-year follow-up from ExCR. Using logistic regression models, patients with PH with an EMR of ExCR were 1:1 propensity score-matched with PH patients without ExCR for age, sex, race, and comorbidities, and cardiovascular care.
In total, 109,736 patients with primary PH met the inclusion criteria for the control group and 784 patients with primary PH met the inclusion criteria for the ExCR cohort. Using the propensity score-matched cohorts, 1-year mortality from ExCR was proportionally lower with 13.6% ( = 101 of 744 patients) in the ExCR cohort compared to 23.3% ( = 174 of 747 patients) in the controls (OR 0.52, 95% CI 0.40-0.68).
The present study of 1,514 patients with primary PH suggests that ExCR is associated with 48% lower odds of 1-year mortality, when compared to propensity score-matched patients without ExCR.
尽管有药物治疗来改善肺动脉高压(PH)的预后,但长期生存率仍然很低。基于运动的心脏康复(ExCR)可能是改善预后的另一种策略。因此,本研究利用电子病历(EMR)数据库,旨在比较接受ExCR的原发性PH患者与倾向评分匹配的未接受ExCR的PH患者之间的死亡率。
2023年2月15日,利用全球联合健康研究网络TriNetX中的匿名数据进行回顾性分析。所有患者年龄≥18岁,EMR中记录有原发性PH,且自ExCR起至少有1年随访。使用逻辑回归模型,将有ExCR电子病历的PH患者与无ExCR的PH患者按年龄、性别、种族、合并症和心血管护理进行1:1倾向评分匹配。
总共有109736例原发性PH患者符合对照组纳入标准,784例原发性PH患者符合ExCR队列纳入标准。使用倾向评分匹配队列,ExCR队列1年死亡率相对较低,ExCR队列中为13.6%(744例患者中有101例),而对照组为23.3%(747例患者中有174例)(OR 0.52,95%CI 0.40 - 0.68)。
本研究纳入1514例原发性PH患者,结果表明,与倾向评分匹配的未接受ExCR的患者相比,ExCR与1年死亡率降低48%相关。