Hedbäck B, Perk J, Wodlin P
Department of Internal Medicine, Oskarshamn District Hospital, Sweden.
Eur Heart J. 1993 Jun;14(6):831-5. doi: 10.1093/eurheartj/14.6.831.
The long-term outcome of different methods of post-MI care has been studied in two non-selected groups of MI patients: an intervention group (n = 147), participating in a cardiac rehabilitation (CR) programme, was compared to a reference group receiving standard care (n = 158). The CR programme included a post-MI clinic, physical training, information on smoking and diet, and psychological support. After 5 years there was no difference in mortality (29.3 vs 31.6%), but the recurrence rate of non-fatal MI (17.3 vs 33.3%, P < 0.05) and of total cardiac events (39.5 vs 53.2%, P < 0.05) was lower in the intervention group, and more patients were still at work (51.8 vs 27.4% P < 0.01). After 10 years there was a reduction in total (42.2 vs 57.6% P < 0.01) and cardiac mortality (36.7 vs 48.1% P < 0.001). Fewer patients in the intervention group suffered from non-fatal reinfarction (28.6 vs 39.9%, P < 0.001). Among those patients who had not yet reached the age of retirement more patients had resumed employment (58.6 vs 22.0% P < 0.05). We conclude, that the secondary preventive effect of the programme has contributed to the higher rate of survival.
在两组未经挑选的心肌梗死（MI）患者中研究了不同心肌梗死后护理方法的长期结果：干预组（n = 147）参加心脏康复（CR）计划，并与接受标准护理的参照组（n = 158）进行比较。CR计划包括心肌梗死后门诊、体育锻炼、吸烟和饮食信息以及心理支持。5年后，两组死亡率无差异（29.3%对31.6%），但干预组非致命性心肌梗死的复发率（17.3%对33.3%，P<0.05）和总心脏事件的复发率（39.5%对53.2%，P<0.05）较低，且仍在工作的患者更多（51.8%对27.4%，P<0.01）。10年后，总死亡率（42.2%对57.6%，P<0.01）和心脏死亡率（36.7%对48.1%，P<0.001）有所降低。干预组发生非致命性再梗死的患者较少（28.6%对39.9%，P<0.001）。在尚未达到退休年龄的患者中，恢复工作的患者更多（58.6%对22.0%，P<0.05）。我们得出结论，该计划的二级预防作用有助于提高生存率。
