Li Peiru, Zhang Wenjie, Wu Beibei
Health Management Center, Affiliated Hospital of Jiangsu University, Zhenjiang, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, People's Republic of China.
J Multidiscip Healthc. 2024 Aug 28;17:4165-4176. doi: 10.2147/JMDH.S483512. eCollection 2024.
Cardiac rehabilitation (CR) is a multidisciplinary intervention program aimed at enhancing the physical, psychological, and social functioning of patients with cardiovascular disease. Although CR is cost-effective and reduces mortality and readmission rates, and many patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) do not adhere to CR. This review aimed to synthesize the evidence on adherence to CR in patients with AMI after PCI (AMI-PCI).
The review was conducted using the methodology proposed by the Joanna Briggs Institute (JBI) to guide reviews and reporting using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extended for Scoping Reviews (PRISMA-ScR). We searched PubMed, Web of Science, CINAHL, Embase, Ovid, and Scopus databases, and two reviewers independently screened the abstracts and full texts of eligible studies against the inclusion and exclusion criteria. Disagreements were resolved in consultation with a third reviewer.
A total of 10 studies were included in the analysis. The results demonstrated that CR reduces the incidence of complications and improves the quality of life of patients with AMI-PCI. However, the CR adherence rate was low, and the factors affecting it are complex and varied, including age, sex, and employment status. Furthermore, interventions to improve adherence in patients with AMI-PCI mainly combined the internet-based interventions, including videoconferencing tele-training, with wearable device monitoring and intelligent management platform follow-up. All these interventions have shown promising results compared with routine care.
Adherence to CR in patients with AMI-PCI is generally low, and CR adherence is affected by many factors; however, relevant research designs are rare and simple. Healthcare professionals should pay more attention to adherence to CR in this population and use a variety of interventions to improve it.
心脏康复（CR）是一项多学科干预计划，旨在提高心血管疾病患者的身体、心理和社会功能。尽管心脏康复具有成本效益且能降低死亡率和再入院率，但许多经皮冠状动脉介入治疗（PCI）后发生急性心肌梗死（AMI）的患者并未坚持心脏康复治疗。本综述旨在综合关于PCI术后AMI患者（AMI-PCI）坚持心脏康复治疗的证据。
本综述采用乔安娜·布里格斯研究所（JBI）提出的方法进行，以指导使用系统评价与Meta分析扩展版的首选报告项目（PRISMA-ScR）进行综述和报告。我们检索了PubMed、科学网、CINAHL、Embase、Ovid和Scopus数据库，两名 reviewers 独立根据纳入和排除标准筛选符合条件研究的摘要和全文。分歧通过与第三位 reviewer 协商解决。
共纳入10项研究进行分析。结果表明，心脏康复可降低AMI-PCI患者并发症的发生率并提高其生活质量。然而，心脏康复的坚持率较低，影响因素复杂多样，包括年龄、性别和就业状况等。此外，提高AMI-PCI患者坚持率的干预措施主要将基于互联网的干预措施（包括视频会议远程培训）与可穿戴设备监测和智能管理平台随访相结合。与常规护理相比，所有这些干预措施均显示出有前景的结果。
AMI-PCI患者对心脏康复的坚持率普遍较低，且心脏康复的坚持受到多种因素影响；然而，相关研究设计少见且简单。医疗保健专业人员应更加关注该人群对心脏康复的坚持情况，并采用多种干预措施来提高坚持率。
