作者：桂沛君，谢瑛，吴坚，吴春薇，郑萍，史昊楠

单位：

100050北京市，首都医科大学附属北京友谊医院康复医学科

Units：

Department of Rehabilitation Medicine, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing 100050, China

关键词：

Keywords：

Myocardial infarction; Percutaneous coronary intervention; Cardiac rehabilitation; Early; Propensity score matching; Patient safety

CLC：

R 542.22

DOI：

10.12114/j.issn.1008-5971.2022.00.227

Funds：

北京市优秀人才培养资助项目（2018000021469G204）；北京市医院管理局“青苗”计划专项（QML20200109）

摘要：

目的　探讨急性心肌梗死（AMI）患者急诊经皮冠状动脉介入治疗（PCI）后行早期心脏康复的安全性。方法　在首都医科大学附属北京友谊医院心血管中心CBD-Bank数据库选取2017年5月至2019年12月住院的AMI患者1 364例，根据纳入与排除标准最终纳入379例行急诊PCI的AMI患者。根据患者是否接受早期心脏康复将其分为心脏康复组（接受早期心脏康复患者，n=79）和对照组（未接受早期心脏康复患者，n=300）。对两组患者基线资料进行1∶1倾向性评分匹配。比较两组患者住院期间主要不良心血管事件（MACE）发生率及随访1年全因死亡率、心源性死亡率、因急性冠脉综合征（ACS）再住院率。结果　匹配后，两组心源性死亡率及靶血管重建、恶性心律失常发生率比较，差异无统计学意义（P ＞0.05）。匹配后，两组随访1年全因死亡率、心源性死亡率比较，差异无统计学意义（P ＞0.05）；心脏康复组随访1年因ACS再住院率低于对照组（P ＜0.05）。结论　AMI患者急诊PCI后开展早期心脏康复相对安全，且早期心脏康复可有效降低AMI患者因ACS再住院率。

Abstract：

Objective　To investigate the safety of early cardiac rehabilitation after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI) . Methods　In the CBD-Bank database of Cardiovascular Center ofCapital Medical University Affiliated Beijing Friendship Hospital, 1 364 AMI patients hospitalized from May 2017 to December2019 were selected. According to the inclusion and exclusion criteria, 379 AMI patients undergoing emergency PCI were finallyincluded. According to whether the patients received early cardiac rehabilitation, they were divided into cardiac rehabilitationgroup (patients receiving early cardiac rehabilitation, n=79) and control group (patients without receiving early cardiacrehabilitation, n=300) . The baseline data of the two groups were matched by 1∶1 propensity score. The incidence of majoradverse cardiovascular events (MACE) during hospitalization and all-cause mortality, cardiogenic mortality and rehospitalizationrate due to acute coronary syndrome (ACS) during 1-year follow-up were compared between the two groups. Results　Aftermatching, there was no significant difference in cardiogenic mortality, incidence of target vessel remodeling and malignantarrhythmias between the two groups (P > 0.05) . After matching, there was no significant difference in all-cause mortality andcardiogenic mortality during 1-year follow-up between the two groups (P > 0.05) ; the rehospitalization rate due to ACS during1-year follow-up in the cardiac rehabilitation group was lower than that in the control group (P < 0.05) . Conclusion　It isrelatively safe for AMI patients to carry out early cardiac rehabilitation after emergency PCI, and early cardiac rehabilitation caneffectively reduce the rehospitalization rate due to ACS of AMI patients.

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