Comparison of cardiac rehabilitation (exercise + education), exercise only, and usual care for patients with coronary artery disease: A non‐randomized retrospective analysis

Abstract

Cardiac rehabilitation program is well‐established but the Rehabilitation After Myocardial Infarction Trial (RAMIT) is reported that it does not affect mortality and morbidity of patients after myocardial infarction during follow‐up period. The objectives of the study were to compare functional walking capacity, risk factor control, and morbidities in follow‐up for cardiac rehabilitation (exercise + education), exercise only, and usual care among patients with coronary artery disease. A total of 492 male and female patients (age range: 45–73 years) with coronary artery disease after myocardial infarction or underwent percutaneous coronary intervention or coronary artery bypass grafting surgeries referred to cardiac rehabilitation were included in the study. Patients were participating in a cardiac rehabilitation program (exercise + education, CRP cohort, n = 125), exercise only (USC cohort, n = 182), or usual care (NCR cohort, n = 185). Data regarding incremental shuttle walk test, lipid profile, the Patient Health Questionnaire 9, and morbidities in follow‐up of patients were retrospectively collected and analyzed. After completion of 1 year, cardiac rehabilitation program (p < 0.0001, q = 20.939) and exercise (p < 0.0001, q = 6.059) were successfully increased incremental shuttle walk test. After completion of 1 year, cardiac rehabilitation program reduced low‐density lipoprotein (p = 0.007, q = 3.349) and depressive symptoms (p < 0.0001, q = 5.649). Morbidities were reported fewer in the patients of CRP cohort than those of USC (p = 0.003, q = 3.427) and NCR (p = 0.003, q = 4.822) cohorts after completion of 1 year of program. Cardiac rehabilitation program (exercise +education) improved functional walking capacity, controlled risk factors, and reduced morbidities of patients with coronary artery disease than exercise only and usual care (Level of evidence: III).

Safety of home-based cardiac rehabilitation: A systematic review

“…40,41 Therefore, it can be assumed that in the HBCR model, mild AEs can be partially prevented by comprehensive baseline education and ongoing telemonitoring. 38,42 Another point that should be discussed is the exercise-related cardiovascular risk stratification of the patients. Recently, an assumption has favored including patients with low to moderate cardiovascular risk in HBCR.…”

Pengaruh Aktivitas Fisik terhadap Profil Lipid Penderita Penyakit Jantung Koroner

“…Namun, dalam beberapa penelitian tidak terdapat perubahan yang bermakna secara statistik. Seperti halnya dengan penelitian oleh Hu et al 12 yang menyatakan setelah satu tahun program, kadar trigliserida secara bermakna lebih rendah pada kelompok cardiac rehabilitation program (CRP) dibandingkan dengan kelompok non cardiac rehabilitation (NCR); kadar kolesterol LDL berkurang untuk kelompok CRP, sedangkan untuk kelompok yang hanya diberi latihan (USC) dan NCR tidak dilaporkan penurunan kadar LDL. Peningkatan kadar HDL terjadi pada kelompok CRP tidak secara bermakna lebih tinggi daripada kelompok USC tetapi secara bermakna lebih tinggi daripada kelompok NCR.…”

“…Peningkatan kadar HDL terjadi pada kelompok CRP tidak secara bermakna lebih tinggi daripada kelompok USC tetapi secara bermakna lebih tinggi daripada kelompok NCR. 12 Hasil penelitian Salehi et al 13 pada 40 pasien PJK melaporkan bahwa perubahan rerata profil lipid pada kelompok latihan resistensi serupa dengan kelompok kontrol yang menjalani latihan rutin unit rehabilitasi (latihan aerobik), dan tidak terdapat perbedaan bermakna antar kelompok. Penelitian tersebut menunjukkan bahwa latihan ketahanan dan daya tahan lebih memengaruhi profil lipid di antara mereka yang memiliki tingkat dasar TG, kolesterol, LDL, dan HDL yang lebih rendah.…”

Tingkat Kualitas Hidup Pasien Setelah IMA dengan Menjalani Program Rehabilitasi Jantung Berbasis Latihan (Literature review)

“…Penyakit kardiovaskular atau Cardiovascular disease (CVD) merupakan pemicu utama kematian diseluruh dunia 30%( 16, 7 juta) dari total kematian secara global 1 , dislipidemia, tekanan darah tinggi, obesitas, diabetes, merokok, stress psikososial, minimnya mengkonsumsi buah dan sayur, mengkonsumsi alkohol, serta kegiatan fisik yang kurang adalah faktor utama infark miokard 2 dan Infark miokard akut (IMA) ini juga bisa menimbulkan kecatatan subtansial serta menjadi pemicu kematian. 3 Berdasarkan riset data World Health Organization (WHO), pada tahun 2016 diperkirakan 17,9 juta orang meninggal dikarenakan penyakit jantung atau Cardiovascular disease (CVD) mewakili sekitar 31% kematian dunia.…”