Zhou Tong, Wang Yijun, Wang Jun, Liu Jinjun, Zhang Nana, Zhang Xiaoling, Yao Shengnan, Tang Mingming, Xu Guixia, Chen Yongxia
Department of Cardiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
West China Hospital, Sichuan University, Chengdu, China.
J Med Internet Res. 2025 Aug 27;27:e75325. doi: 10.2196/75325.
Cardiac rehabilitation (CR) interventions for patients with coronary heart disease are increasingly adopted. However, research on the integration of digital health technologies into CR for patients with unstable angina (UA) undergoing percutaneous coronary intervention (PCI) remains limited.
This study assessed the effectiveness of a multidimensional digital CR program for patients with UA undergoing PCI.
This prospective study enrolled 164 patients with UA who underwent PCI between April and June 2022. Patients were assigned to either the usual care group (April-May 2022) or the multidimensional digital CR intervention group (May-June 2022). The intervention group received rehabilitation through a nurse-led, multidisciplinary team, using a customized digital CR program. This program encompassed 7 key rehabilitation components: exercise, medication management, nutritional guidance, psychological support, sleep management, health education, and smoking cessation assistance. The usual care group received standardized treatment and routine nursing care. To minimize selection bias, propensity score matching was applied between the 2 groups. The primary outcomes included changes in the 6-minute walk test (6MWT), 12-item Short Form Health Survey (SF-12) scores, and frailty phenotype scores at 3 months. Secondary outcomes assessed differences in gait speed, 30-second chair stand test (30-s CST), grip strength, waist circumference (WC), BMI, and lipid profiles at 3 months.
A total of 136 patients were included in the final analysis. At 3 months, the intervention group demonstrated significant improvements in frailty status compared to the control group. The proportion of prefrail patients decreased from 100% (68 patients) to 75% (51 patients), while nonfrail patients increased from 0% to 25% (17 patients; P<.001). Regarding physical fitness, the intervention group exhibited improvements in 6MWT: from 347.06 (SD 32.43) to 375.22 (SD 29.71) m (P<.001); gait speed: from 0.87 (SD 0.17) to 1.05 (SD 0.14) m/s (P<.001); and 30-s CST: from 10.0 (SD 1.89) to 12.71 (SD 1.97; P<.001). Grip strength, BMI, and WC improved significantly in the intervention group. Grip strength increased from 16.64 (SD 6.57) to 20.74 (SD 5.37; P<.001). BMI decreased from 25.74 (SD 3.05) to 23.88 (SD 2.14; P<.001), and WC decreased from 94.98 (SD 7.87) to 89.91 (SD 7.50) cm (P<.001). The intervention group achieved greater improvements in lipid profiles, with significant reductions in total cholesterol (P<.001), triglycerides (P<.001), and low-density lipoprotein cholesterol (P<.001), while high-density lipoprotein cholesterol remained stable (P=.45).
This study demonstrates that a novel multidimensional digital CR program is acceptable and effective in improving functional status and health-related quality of life in patients with UA undergoing PCI within a short timeframe.
冠心病患者的心脏康复（CR）干预措施越来越多地被采用。然而，将数字健康技术整合到接受经皮冠状动脉介入治疗（PCI）的不稳定型心绞痛（UA）患者的CR中的研究仍然有限。
本研究评估了针对接受PCI的UA患者的多维数字CR计划的有效性。
这项前瞻性研究纳入了2022年4月至6月期间接受PCI的164例UA患者。患者被分配到常规护理组（2022年4月至5月）或多维数字CR干预组（2022年5月至6月）。干预组通过护士主导的多学科团队，使用定制的数字CR计划接受康复治疗。该计划包括7个关键康复组成部分：运动、药物管理、营养指导、心理支持、睡眠管理、健康教育和戒烟援助。常规护理组接受标准化治疗和常规护理。为了尽量减少选择偏倚，在两组之间应用了倾向得分匹配。主要结局包括3个月时6分钟步行试验（6MWT）、12项简短健康调查（SF-12）评分和衰弱表型评分的变化。次要结局评估了3个月时步态速度、30秒椅子站立试验（30-s CST）、握力、腰围（WC）、体重指数（BMI）和血脂谱的差异。
共有136例患者纳入最终分析。3个月时，与对照组相比，干预组的衰弱状态有显著改善。衰弱前期患者的比例从100%（68例患者）降至75%（51例患者），而非衰弱患者从0%增至25%（17例患者；P<0.001）。在体能方面，干预组在6MWT方面有改善：从347.06（标准差32.43）米增至375.22（标准差29.71）米（P<0.001）；步态速度：从0.87（标准差0.17）米/秒增至1.05（标准差0.14）米/秒（P<0.001）；以及30-s CST：从10.0（标准差1.89）次增至12.71（标准差1.97；P<0.001）。干预组的握力、BMI和WC有显著改善。握力从16.64（标准差6.57）增至20.74（标准差5.37；P<0.001）。BMI从25.74（标准差3.05）降至23.88（标准差2.14；P<0.001），WC从94.98（标准差7.87）厘米降至89.91（标准差7.50）厘米（P<0.001）。干预组的血脂谱有更大改善，总胆固醇（P<0.001）、甘油三酯（P<0.001）和低密度脂蛋白胆固醇（P<0.001）显著降低，而高密度脂蛋白胆固醇保持稳定（P=0.45）。
本研究表明，一种新型的多维数字CR计划在短期内改善接受PCI的UA患者的功能状态和健康相关生活质量方面是可接受且有效的。
