Trauma research center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, Iran.
High Blood Press Cardiovasc Prev. 2024 Mar;31(2):189-204. doi: 10.1007/s40292-024-00636-2. Epub 2024 Apr 2.
Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack.
To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program.
This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL).
The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group.
This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations.
This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.
心脏康复（CR）在降低心血管事件风险和提高心肌梗死后患者生活质量方面发挥着关键作用。
评估实施以家庭为中心的赋权模型（FCEM）为重点的混合心脏康复计划后，心肌梗死（MI）幸存者的死亡率和效果稳定性。
这项双盲随机对照临床试验在伊朗德黑兰的 Shariati 医院（一所学术教学医院）进行（2012-2023 年），共涉及 70 名 MI 患者及其家属。参与者被随机分配到 FCEM 干预组或标准 CR 对照组。该干预在 MI 患者从 CCU 安全出院后开始，并持续整个 10 年随访期。使用各种问卷收集死亡率和健康相关生活质量（HRQoL）数据。
在 10 年随访期间，干预组的死亡率较低（5 年、7 年和 10 年分别为 5.7%、11.4%和 17.1%），而对照组分别为 20%、37.1%和 48.9%。在校正年龄、性别和 BMI 后，对照组的死亡率风险高 4 倍（HR：4.346，95%CI 1.671-7.307，P=0.003）。FCEM 为重点的方案在 48 个月内对参与者的生活质量产生了显著且持续的积极影响，与对照组相比，改善程度更大。
本研究强调了基于 FCEM 的混合 CR 计划在改善 MI 幸存者的长期患者结局和降低死亡率方面的有效性。需要进一步研究以在更大样本和不同人群中探索潜在的益处。
这项研究（标识符：NCT02402582）于 2015 年 3 月 30 日在 ClinicalTrials.gov 上注册。
