Jo Sojeong, Lee Haejung, Park Gaeun
College of Nursing, Pusan National University, Yangsan, Korea.
College of Nursing·Research Institute of Nursing Science, Pusan National University, Yangsan, Korea.
J Korean Acad Nurs. 2024 Aug;54(3):311-328. doi: 10.4040/jkan.24019.
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).
本研究通过系统评价和荟萃分析，探讨非药物干预对接受经皮冠状动脉介入治疗（PCI）的冠心病患者主要不良心血管事件（MACE）的影响。
截至2023年11月，使用PubMed、Cochrane图书馆、EMBASE和护理及联合健康文献累积索引数据库进行文献检索。使用Cochrane偏倚风险2.0工具评估偏倚风险。使用R软件（版本4.3.2）计算效应量和95%置信区间。
纳入18项随机研究，涉及2898名参与者。其中，16项研究（2697名参与者）提供了定量数据。非药物干预（教育、运动和综合干预）显著降低了心绞痛、心力衰竭、心肌梗死、再狭窄、心血管相关再入院和心血管相关死亡的风险。亚组荟萃分析表明，联合干预可有效降低心肌梗死（MI）的发生率，基于个体和小组的干预对降低MACE的发生率有显著效果。在持续7个月或更长时间的干预中，发生率降低了0.16倍，心血管疾病相关死亡率降低了0.44倍，表明持续7个月或更长时间的干预在降低MI和心血管疾病相关死亡率方面更有效。
需要进一步研究评估这些干预措施在接受PCI患者中的成本效益，并验证其短期和长期效果。本系统评价强调了非药物干预在降低MACE发生率方面的潜力，并突出了该领域持续研究的重要性（PROSPERO注册号：CRD42023462690）。
