Department of Cardiology, Taizhou School of Clinical Medicine, Nanjing Medical University, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu Province, 225300, People's Republic of China.
Panvascular Management Center, Taizhou School of Clinical Medicine, Nanjing Medical University, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu Province, 225300, People's Republic of China.
Clin Interv Aging. 2024 Aug 24;19:1471-1478. doi: 10.2147/CIA.S474811. eCollection 2024.
Management strategies for stable angina include pharmacotherapy, revascularization, and exercise-based cardiac rehabilitation (CR). The optimal treatment for stable angina patients with severe coronary artery stenosis remains unclear. This study aimed to compare interventional therapy with exercise rehabilitation in this population.
Fifty stable angina patients with severe coronary stenosis who underwent stent implantation were included in the optimal medical therapy (OMT) plus percutaneous coronary intervention (PCI) group, and 50 patients who did not undergo interventional treatment were included in OMT plus CR group receiving exercise rehabilitation guidance for one year. Cardiovascular composite endpoint events, cardiopulmonary fitness, and quality of life scale scores were assessed after one year.
No significant difference in incidence of cardiovascular composite endpoint events was observed between OMT plus PCI group with OMT plus CR group (20.0% vs 14.6%) after one year. Cardiopulmonary fitness represented as peak VO (19.2±3.5 vs 17.6±3.2 mL/kg/min), peak load (120±19 vs 108±20 W), and AT (13.5±1.5 vs 12.1±1.3 mL/kg/min) were significantly higher in the rehabilitation group than the intervention group after one year. Both groups showed improvement in their quality of life, but the rehabilitation group improved in more scales.
Interventional therapy did not reduce cardiovascular events compared to exercise-based rehabilitation in stable angina patients with severe coronary artery stenosis, but the rehabilitation can improve cardiovascular fitness and quality of life more.
稳定型心绞痛的治疗策略包括药物治疗、血运重建和基于运动的心脏康复（CR）。对于严重冠状动脉狭窄的稳定型心绞痛患者，最佳治疗方法仍不明确。本研究旨在比较介入治疗与该人群的运动康复。
将 50 例接受支架植入术的严重冠状动脉狭窄稳定型心绞痛患者纳入最佳药物治疗（OMT）加经皮冠状动脉介入治疗（PCI）组，50 例未接受介入治疗的患者纳入 OMT 加 CR 组，接受为期一年的运动康复指导。一年后评估心血管复合终点事件、心肺适能和生活质量量表评分。
一年后，OMT 加 PCI 组与 OMT 加 CR 组心血管复合终点事件发生率无显著差异（20.0%比 14.6%）。心肺适能表现为峰值 VO（19.2±3.5 比 17.6±3.2 mL/kg/min）、峰值负荷（120±19 比 108±20 W）和 AT（13.5±1.5 比 12.1±1.3 mL/kg/min），康复组一年后明显高于干预组。两组生活质量均有改善，但康复组在更多的量表中改善。
与严重冠状动脉狭窄的稳定型心绞痛患者的基于运动的康复相比，介入治疗并未降低心血管事件，但康复治疗可以更有效地提高心血管适能和生活质量。
