SMARTphone-based, early cardiac REHABilitation in patients with acute coronary syndromes: a randomized controlled trial.


Journal

Coronary artery disease
ISSN: 1473-5830
Titre abrégé: Coron Artery Dis
Pays: England
ID NLM: 9011445

Informations de publication

Date de publication:
01 Aug 2021
Historique:
pubmed: 2 9 2020
medline: 15 1 2022
entrez: 2 9 2020
Statut: ppublish

Résumé

There are well-documented treatment gaps in secondary prevention of coronary heart disease with a lack of clearly defined strategies to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps. The primary goal of this study was to assess whether a smartphone-based, early cardiac rehabilitation program improved exercise capacity in patients with ACS. A total of 206 patients with ACS across six tertiary Australian hospitals were included in this randomized controlled trial. Participants were randomized to usual care (UC; including referral to traditional cardiac rehabilitation), with or without an adjunctive smartphone-based cardiac rehabilitation program (S-CRP) upon hospital discharge. The primary endpoint was change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline, between groups. Secondary endpoints included uptake and adherence to cardiac rehabilitation, changes in cardiac risk factors, psychological well-being and quality of life status. Of the 168 patients with complete follow-up (age 56 ± 10 years; 16% females), 83 were in the S-CRP. At 8-week follow-up, the S-CRP group had a clinically significant improvement in 6-minute walk test distance (Δ117 ± 76 vs. Δ91 ± 110 m; P = 0.02). Patients in the S-CRP were more likely to participate (87% vs. 51%, P < 0.001) and adhere (72% vs. 22%, P < 0.001) to a cardiac rehabilitation program. Compared to UC, patients receiving S-CRP had similar smoking cessation rates, LDL-cholesterol levels, blood pressure reduction, depression, anxiety and quality of life measures (all P = NS). In patients with ACS, a S-CRP, as an adjunct to UC improved exercise capacity at 8 weeks in addition to participation and adherence to cardiac rehabilitation (Australian New Zealand Clinical Trials Registry; ACTRN12616000426482).

Sections du résumé

BACKGROUND BACKGROUND
There are well-documented treatment gaps in secondary prevention of coronary heart disease with a lack of clearly defined strategies to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps.
OBJECTIVES OBJECTIVE
The primary goal of this study was to assess whether a smartphone-based, early cardiac rehabilitation program improved exercise capacity in patients with ACS.
METHODS METHODS
A total of 206 patients with ACS across six tertiary Australian hospitals were included in this randomized controlled trial. Participants were randomized to usual care (UC; including referral to traditional cardiac rehabilitation), with or without an adjunctive smartphone-based cardiac rehabilitation program (S-CRP) upon hospital discharge. The primary endpoint was change in exercise capacity, measured by the change in 6-minute walk test distance at 8 weeks when compared to baseline, between groups. Secondary endpoints included uptake and adherence to cardiac rehabilitation, changes in cardiac risk factors, psychological well-being and quality of life status.
RESULTS RESULTS
Of the 168 patients with complete follow-up (age 56 ± 10 years; 16% females), 83 were in the S-CRP. At 8-week follow-up, the S-CRP group had a clinically significant improvement in 6-minute walk test distance (Δ117 ± 76 vs. Δ91 ± 110 m; P = 0.02). Patients in the S-CRP were more likely to participate (87% vs. 51%, P < 0.001) and adhere (72% vs. 22%, P < 0.001) to a cardiac rehabilitation program. Compared to UC, patients receiving S-CRP had similar smoking cessation rates, LDL-cholesterol levels, blood pressure reduction, depression, anxiety and quality of life measures (all P = NS).
CONCLUSION CONCLUSIONS
In patients with ACS, a S-CRP, as an adjunct to UC improved exercise capacity at 8 weeks in addition to participation and adherence to cardiac rehabilitation (Australian New Zealand Clinical Trials Registry; ACTRN12616000426482).

Identifiants

pubmed: 32868661
pii: 00019501-202108000-00012
doi: 10.1097/MCA.0000000000000938
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

432-440

Informations de copyright

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Références

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Auteurs

Matias B Yudi (MB)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

David J Clark (DJ)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

David Tsang (D)

Department of Cardiology, Western Health.

Michael Jelinek (M)

Department of Medicine, University of Melbourne.
Department of Cardiology, St Vincent's Hospital.

Katie Kalten (K)

Department of Cardiology, Austin Health.

Subodh B Joshi (SB)

Department of Cardiology, Royal Melbourne Hospital.

Khoa Phan (K)

Department of Cardiology, Royal Melbourne Hospital.

Jay Ramchand (J)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

Arthur Nasis (A)

Monash Heart, Monash Health, Melbourne.

John Amerena (J)

School of Public Health, Curtin University, Perth, Western Australia, Australia.

Anoop N Koshy (AN)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

Alexandra C Murphy (AC)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

Sandeep Arunothayaraj (S)

Department of Cardiology, St Vincent's Hospital.

Si Si (S)

School of Public Health, Curtin University, Perth, Western Australia, Australia.

Christopher M Reid (CM)

School of Public Health, Curtin University, Perth, Western Australia, Australia.

Omar Farouque (O)

Department of Cardiology, Austin Health.
Department of Medicine, University of Melbourne.

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