Impact of a brief psychological intervention on lifestyle, risk factors and disease knowledge during phase I of cardiac rehabilitation after acute coronary syndrome

(1) Background: Cardiac rehabilitation is a multidisciplinary program that includes psychoeducational support in addition to physical exercise. Psychoeducational intervention is a component that has had accelerated interest and development in recent decades. The aim was to analyze the current evidence on the effectiveness of psychoeducational interventions for patients with acute coronary syndrome (ACS). (2) Methods: We conducted a systematic search of the literature via four databases: PubMed, CENTRAL, PsycINFO, and EMBASE. We included randomized controlled trials that evaluated the effectiveness of a psychoeducational intervention compared to usual care in ACS patients. We assessed the risk of bias using a modified version of the Cochrane tool. We analyzed data regarding the population, intervention, comparator, outcomes, and timing. (3) Results: We identified 6248 studies. After a rigorous screening, we included in the analysis 11 articles with a total of 3090 participants. Major adverse cardiovascular events, quality of life, hospitalizations, lipidogram, creatinine, NYHA class, smoking, physical behavior, and emotional state were significantly improved. In addition, illness perception, knowledge, and beliefs were substantially ameliorated (all p < 0.001). All this was related to the type and dose of psychological intervention. (4) Conclusions: Patients with ACS can receive significant benefits through individualized psychoeducation sessions. The cardiac rehabilitation program should include personalized psychological and educational intervention by type and dose.

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In-hospital psychological intervention in cardiac rehabilitation following acute coronary syndrome: Brief is better than nothing

Revista Portuguesa de Cardiologia (English Edition) ◽

10.1016/j.repce.2019.06.008 ◽

2019 ◽

Vol 38 (5) ◽

pp. 369-372

Author(s):

Ana Abreu

Keyword(s):

Acute Coronary Syndrome ◽

Cardiac Rehabilitation ◽

Psychological Intervention ◽

Coronary Syndrome ◽

Better Than

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Third phase of cardiac rehabilitation after acute coronary syndrome: prevalence of diabetes and its risk factors

Russian Medical Inquiry ◽

10.32364/2587-6821-2021-5-4-176-184 ◽

2021 ◽

Vol 5 (4) ◽

pp. 176-184

Author(s):

I.V. Druk ◽

◽

O.Yu. Korennova ◽

M.V. Savchenko ◽

L.V. Shukil ◽

...

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Blood Glucose ◽

Cardiac Rehabilitation ◽

De Novo ◽

Shape Index ◽

Coronary Syndrome ◽

Third Phase ◽

A Body Shape Index

Aim: to determine risk factors for type 2 diabetes (T2D) in patients with the prior acute coronary syndrome (ACS) in the 3rd phase of cardiac rehabilitation. Patients and Methods: retrospective analysis of medical records of 200 patients (151 men, 75.5%) was performed. The mean age was 61.7±9.6 years. All patients attended a 12-month cardiac rehab program that included adequate pharmacotherapy (atorvastatin monotherapy or atorvastatin plus ezetimibe), physical and psychological rehabilitation, therapeutic feeding, and preventive group consultations (health schools). Both quantitative (fasting blood glucose, weight, body mass index, waist circumference, hip circumference, a body shape index) and qualitative (overweight, obesity, other risk factors for T2D, diabetes, de novo diabetes) parameters were studied. Results: in patients with prior ACS, a high prevalence of conventional and additional risk factors for T2D (≥ 6 risk factors were revealed in 90% of patients) was reported in the 3rd phase of cardiac rehab. After completing the cardiac rehab program, the prevalence of T2D in patients with prior ACS was 24% thereby demonstrating a significant increase (p < 0.05). Additionally, a significant increase in the proportion of patients with high normal blood glucose (5.0–6.0 mmol/l) was reported. Unfavorable de novo abnormalities of carbohydrate metabolism (pre-diabetes, T2D plus pre-diabetes) were commonly revealed in patients with high normal blood glucose. Cardiac rehab program provided weight control in patients with T2D risk. A significant increase in waist circumference, a body shape index, the waist-to-height ratio was reported thus demonstrating redistribution of fat mass and an increase in visceral fat. These signs may indicate an unfavorable trend of increased insulin resistance. Conclusions: searching for risk factors of unfavorable metabolic abnormalities identified and means to optimize management of these patients (including medical treatment) based on the assessment of metabolic benefits and drawbacks is required. KEYWORDS: acute coronary syndrome, cardiac rehabilitation, type 2 diabetes, pre-diabetes, insulin resistance, risk factors, statins. FOR CITATION: Druk I.V., Korennova O.Yu., Savchenko M.V. et al. Third phase of cardiac rehabilitation after acute coronary syndrome: prevalence of diabetes and its risk factors. Russian Medical Inquiry. 2021;5(4):176–184 (in Russ.). DOI: 10.32364/2587-6821-2021- 5-4-176-184.

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