Association between home-based exercise using a pedometer and clinical prognosis after endovascular treatment in patients with peripheral artery disease.


Journal

Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703

Informations de publication

Date de publication:
02 2023
Historique:
received: 02 06 2022
revised: 20 08 2022
accepted: 31 08 2022
pubmed: 21 9 2022
medline: 21 12 2022
entrez: 20 9 2022
Statut: ppublish

Résumé

Exercise therapy following endovascular treatment (EVT) is important for patients with peripheral artery disease (PAD); however, continuous exercise therapy is difficult to be performed in clinical practice. This study aimed to investigate the association between the implementation of home-based exercise using pedometers after EVT and 1-year clinical outcomes. This multicenter observational prospective cohort registry included patients with PAD complaining of intermittent claudication who underwent EVT for aortoiliac and/or femoropopliteal artery lesions between January 2016 and March 2019. Patients were instructed to perform home-based exercises using a specific pedometer after EVT. The study population was divided into good and poor recording groups according to the frequency of the pedometer measurements. The good recording group was defined as those who completed ≥50 % of the prescribed daily pedometer recording during the follow-up period. The poor recording group was defined as those with an inability to use a pedometer and/or who completed <50 % of the prescribed daily pedometer recordings. The primary outcome was 1-year major adverse events (MAE), defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, target vessel revascularization, and major amputation of the target limb. The mean age was 74.4 years; 78 % were male. A total of 623 lesions were analyzed (58.7 % aortoiliac, 41.3 % femoropopliteal). At 1 year, a lower cumulative incidence of MAE was observed in the good recording group compared to that in the poor recording group [10/233 (4.3 %) vs. 35/267 (13.7 %) patients, respectively; p < 0.001]. Multivariate Cox regression analysis showed that patients in the good recording group had a lower hazard ratio for 1-year MAE (0.33; 95 % confidence interval, 0.16-0.68; p = 0.004) than that in the poor recording group. Good self-recording of pedometer measurements was associated with favorable prognosis in patients with PAD following EVT.

Sections du résumé

BACKGROUND
Exercise therapy following endovascular treatment (EVT) is important for patients with peripheral artery disease (PAD); however, continuous exercise therapy is difficult to be performed in clinical practice. This study aimed to investigate the association between the implementation of home-based exercise using pedometers after EVT and 1-year clinical outcomes.
METHODS
This multicenter observational prospective cohort registry included patients with PAD complaining of intermittent claudication who underwent EVT for aortoiliac and/or femoropopliteal artery lesions between January 2016 and March 2019. Patients were instructed to perform home-based exercises using a specific pedometer after EVT. The study population was divided into good and poor recording groups according to the frequency of the pedometer measurements. The good recording group was defined as those who completed ≥50 % of the prescribed daily pedometer recording during the follow-up period. The poor recording group was defined as those with an inability to use a pedometer and/or who completed <50 % of the prescribed daily pedometer recordings. The primary outcome was 1-year major adverse events (MAE), defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, target vessel revascularization, and major amputation of the target limb.
RESULTS
The mean age was 74.4 years; 78 % were male. A total of 623 lesions were analyzed (58.7 % aortoiliac, 41.3 % femoropopliteal). At 1 year, a lower cumulative incidence of MAE was observed in the good recording group compared to that in the poor recording group [10/233 (4.3 %) vs. 35/267 (13.7 %) patients, respectively; p < 0.001]. Multivariate Cox regression analysis showed that patients in the good recording group had a lower hazard ratio for 1-year MAE (0.33; 95 % confidence interval, 0.16-0.68; p = 0.004) than that in the poor recording group.
CONCLUSIONS
Good self-recording of pedometer measurements was associated with favorable prognosis in patients with PAD following EVT.

Identifiants

pubmed: 36126908
pii: S0914-5087(22)00228-3
doi: 10.1016/j.jjcc.2022.09.005
pii:
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

222-228

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that there is no conflict of interest.

Auteurs

Kohei Kawamura (K)

Department of Cardiovascular Medicine, Okayama City Hospital, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Kentaro Ejiri (K)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Hironobu Toda (H)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Electronic address: hiromail1979@s.okayama-u.ac.jp.

Toshiaki Yamanaka (T)

Department of Cardiology, Tsuyama Chuo Hospital, Tsuyama, Japan.

Masato Taniguchi (M)

Department of Cardiovascular Medicine, Fukuyama Cardiovascular Hospital, Fukuyama, Japan.

Kenji Kawamoto (K)

Department of Cardiology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.

Koji Tokioka (K)

Department of Cardiovascular Medicine, Okayama City Hospital, Okayama, Japan.

Yoichiro Naito (Y)

Department of Cardiovascular Medicine, Fukuyama City Hospital, Fukuyama, Japan.

Ryo Yoshioka (R)

Department of Cardiovascular Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan.

Eiji Karashima (E)

Department of Cardiology, Shimonoseki City Hospital, Shimonoseki, Japan.

Hideki Fujio (H)

Department of Cardiovascular Medicine, Himeji Red Cross Hospital, Himeji, Japan.

Soichiro Fuke (S)

Department of Cardiovascular Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan.

Yasukazu Fujiwara (Y)

Department of Cardiovascular Internal Medicine, Kagawa Rosai Hospital, Marugame, Japan.

Atsushi Takaishi (A)

Department of Cardiology, Mitoyo General Hospital, Himehama, Kanonji, Japan.

Kosuke Seiyama (K)

Division of Cardiovascular Disease, Sumitomo Besshi Hospital, Niihama, Japan.

Toru Miyoshi (T)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Kazufumi Nakamura (K)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Hiroshi Ito (H)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

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