scholarly journals Assessment of coronary artery disease patient eligibility to phase 3 cardiac rehabilitation in the outpatient settings after myocardial revascularization

2021 ◽  
Vol 10 (1) ◽  
pp. 16-25
Author(s):  
O. Yu. Korennova ◽  
E. P. Prihodko ◽  
Yu. E. Yukhina ◽  
M. V. Savchenko ◽  
E. A. Turusheva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Myocardial Revascularization ◽  
Phase 3 ◽  
Rehabilitation Team ◽  
Exercise Rehabilitation ◽  
Artery Disease

Aim. To determine the clinical factors affecting the timely reference of patients with coronary artery disease after myocardial revascularization to Phase 3 cardiac rehabilitation.Methods. 773 patients with coronary artery disease (CAD) who underwent myocardial revascularization were recruited in a study. Of them, 77 (9.96%) underwent coronary artery bypass grafting and 696 (90.04%) underwent PCI. Within 1 month of discharge, patients were examined by a cardiologist in the outpatient hospital and then referred to the cardiac rehabilitation team to assess their eligibility. The eligibility for exercise rehabilitation was assessed based on the results of general examination, clinical and laboratory findings. The prevalence of absolute and relative contraindications to exercise rehabilitation was measured.Results. 10% of CAD patients after myocardial revascularization had absolute contraindications and 29.6% had relative contraindications to exercise rehabilitation. The presence of relative contraindications (exaggerated blood pressure response (>80/100 mm Hg) to exercise or a decrease in systolic blood pressure ≥20 mm Hg, ventricular extrasystole and tachycardia, paroxysmal tachyarrhythmias in response to exercise, active gastroduodenal ulcer, and less than 1 month after its exacerbation, moderate heart valvular disease (aortic stenosis), decompensated carbohydrate metabolism disorders) required the management of risk factors limiting patients on the participation in exercise rehabilitation. The routing of CAD patients after myocardial revascularization at Phase 3 cardiac rehabilitation was developed and introduced in the Clinical Cardiological Dispensary in the Omsk region.Conclusion. Most patients with CAD after myocardial revascularization should be referred to exercise rehabilitation. These patients rarely have absolute contraindications (about 10%). Despite relative contraindications are rather high (about 30%), risk factors limiting patient participation in exercise rehabilitation are managed successfully. Optimal routing of patients contributes to their prompt recruiting to cardiac rehabilitation. Effective management of cardiovascular risk factors allows recruiting more patients in exercise rehabilitation.

scholarly journals Efficacy of Smartphone-Based Secondary Preventive Strategies in Coronary Artery Disease

2020 ◽  
Vol 14 ◽  
pp. 117954682092740
Author(s):  
Alexandra C Murphy ◽  
Georgina Meehan ◽  
Anoop N Koshy ◽  
Phelia Kunniardy ◽  
Omar Farouque ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Systolic Blood Pressure ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Established Coronary Artery Disease ◽  
Rehabilitation Programs ◽  
Artery Disease

Background: Cardiac rehabilitation programs provide a comprehensive framework for the institution of secondary preventive measures. Smartphone technology can provide a platform for the delivery of such programs and is a promising alternative to hospital-based services. However, there is limited evidence to date supporting this approach. Accordingly, we performed a systematic review and meta-analysis examining smartphone-based secondary prevention programs to traditional cardiac rehabilitation in patients with established coronary artery disease to ascertain the feasibility and effectiveness of these interventions. Methods: A systematic search of PubMed, MEDLINE, EMBASE, and the Cochrane Library was conducted. A meta-analysis was performed using a random-effects model with the outcomes of interest being 6-minute walk test (6MWT) distance, systolic blood pressure, low-density lipoprotein (LDL) cholesterol, and body mass index (BMI). Results: A total of 8 studies with 1120 patients across 5 countries were included in the quantitative analysis. Follow-up ranged from 6 weeks to 12 months. Five studies examined all patients post acute coronary syndrome, 2 studies examined only patients undergoing percutaneous coronary intervention, and 1 study examined all patients with a diagnosis of coronary artery disease, independent of intervention. Exercise capacity, as measured by the 6MWT, was significantly greater in the smartphone group (20.10 meters, 95% confidence interval [CI] 7.44-33.97; P < .001; I2 = 45.58). There was no significant difference in BMI reduction, systolic blood pressure, or LDL cholesterol levels between groups ( P value for all > .05). Conclusion: Publicly available smartphone-based cardiac rehabilitation programs are a convenient and easily disseminated intervention which show merit in exercise promotion in patients with established coronary artery disease. Further research is required to establish the clinical significance of recent findings favoring their use.

Serum chromium and angiographically determined coronary artery disease.

1978 ◽  
Vol 24 (4) ◽  
pp. 541-544 ◽  
Author(s):  
H A Newman ◽  
R F Leighton ◽  
R R Lanese ◽  
N A Freedland
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Plaque Formation ◽  
Atheromatous Plaque ◽  
Lower Serum ◽  
Serum Chromium ◽  
Artery Disease

Abstract Human aortas sampled from populations where there is little advanced atheromatous plaque formation contain higher concentrations of chromium than do aortas from populations in which atheromatosis is prevalent. In the present study serum cholesterol, triacylglycerols, and chromium (Cr3+) concentrations were measured in 32 subjects in whom coronary artery disease was assessed by cineangiography. The distribution of subjects with diseased and normal arteries overlapped below 5.50 microgram of chromium per liter. Only subjects free of coronary artery disease had chromium concentrations greater than or equal to 5.50 microgram/liter. The role of chromium was assessed in the context of the selected risk factors: cholesterol, triacylglycerols, and systolic and diastolic blood pressure. The group with coronary artery disease had significantly lower serum chromium concentrations than did the group with normally patent arteries.

Cardiac rehabilitation training program focused on risk factors of coronary artery disease

2017 ◽  
Vol 263 ◽  
pp. e110
Author(s):  
Robert Vysoký ◽  
Filip Dosbaba ◽  
Ladislav Batalik ◽  
Svatopluk Nehyba ◽  
Václav Chaloupka
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Training Program ◽  
Rehabilitation Training ◽  
Artery Disease

Association of low serum concentration of bilirubin with increased risk of coronary artery disease

1994 ◽  
Vol 40 (1) ◽  
pp. 18-23 ◽  
Author(s):  
H A Schwertner ◽  
W G Jackson ◽  
G Tolan
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Systolic Blood Pressure ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Smoking History ◽  
Artery Disease

Abstract We examined serum bilirubin and various liver-function enzymes as possible risk factors for angiographically documented coronary artery disease (CAD). The studies involved a "training" set of 619 men for whom complete data on all risk factors considered were available, and a "test" set of 258 men for whom some risk factor data were not available. In both study groups, the liver enzymes were not related to CAD; however, In[total bilirubin] was inversely and statistically significantly related to the presence of CAD, both univariately and multivariately after adjustment for the established risk factors of age, total cholesterol, high-density lipoprotein cholesterol, smoking history, and systolic blood pressure. A 50% decrease in total bilirubin was associated with a 47% increase in the odds of being in a more severe CAD category. Our data suggest that serum bilirubin is an inverse and independent risk factor for CAD, with an association equivalent in degree to that of systolic blood pressure.

scholarly journals Temporal changes in the implementation of secondary prevention of coronary artery disease in every day practice

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
JW Peksa ◽  
P Jankowski ◽  
P Koziel ◽  
P Bogacki ◽  
P Gomula ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Body Mass Index ◽  
Coronary Artery ◽  
Confidence Intervals ◽  
Body Mass ◽  
Ldl Cholesterol ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf - Introduction Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events and control of their risk factors is crucial. Objectives Comparison of risk factors control in patients with CAD in 2016–2017 and 2011–2013. Patients and methods Five hospitals with cardiology departments serving the city and surrounding districts participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or a myocardial revascularization procedure were interviewed 6–18 months after hospitalization. The surveys were carried out in 2011–2013 and 2016–2017. Results We examined 616 patients in 2011–2013 and 388 in 2016–2017 (mean age: 64.7 ± 8.8 vs. 66.4 ± 8.4, P &lt;0.01). After adjusting for covariates the proportion of patients with high blood pressure decreased by 8.9% (95% confidence intervals: -2.1% – -15.6%) and proportion of patients with high LDL cholesterol decreased by 9.5% (-2.2% – -16.7%) in 2016/2017 compared to 2011/2013, whereas the proportion of smoking patients (-0.2% [-6.0% – 5.5%]) and those with high glucose level (3.9% [-2.2% - 10.0%]) and with body mass index ≥25 kg/m2 (3.8% [-3.9% – 11.6%]) did not change significantly. The proportion of patients prescribed antiplatelets (6.5% [2.6% - 10.3%]), β-blockers (7.4% [2.2% - 12.6%]), angiotensin converting enzyme inhibitors or sartans (8.6% [2.9% – 14.3%]), calcium antagonists (8.1% [1.3 – 15.0]) and anticoagulants (5.5% [0.7% - 10.2%]) increased significantly. Conclusions In CAD patients, there was an increase of the proportion of patients with cardiovascular drugs prescribed and a slight improvement in the control of blood pressure and LDL cholesterol between 2011–2013 and 2016–2017. However, no significant changes were found for the other main risk factors. Patients who do not reach treatment goal Survey Smoking, % BP not at goal, %a BP ≥140/90 mmHg, % LDL cholesterol ≥1.8 mmol/l, % HbA1c ≥7.0%b, % Fasting glucose ≥7.0 mmol/l, % BMI≥25 kg/m2, % BMI≥30 kg/m2, % 2011-2013 19.0 50.3 43.0 71.9 14.1 15.9 81.2 33.8 2016-2017 16.2 40.7 39.2 60.3 14.9 20.2 83.4 38.3 P value 0.26 &lt;0.01 0.24 &lt;0.001 0.76 0.09 0.37 0.14 Differences adjusted for age, sex, index diagnosis, duration of education, professional activity (95% confidence intervals) 2016-2017 vs 2011-2013 -0.2(-6.0 - 5.5) -8.9(-15.6 - -2.1) -6.7(-14.3 - 1.0) -9.5(-16.7 - -2.2) 2.0(-3.4 - 7.4) 3.9(-2.2 - 10.0) 3.8(-3.9 - 11.6) 1.6 (-5.8 - 9.0) Abbreviations BMI, body mass index; BP, blood pressure; LDL, low-density lipoprotein a BP goal of &lt;140/90mmHg (&lt;130/80 mmHg in diabetics) in 2011–2013 and &lt;140/90 mmHg (&lt;140/85 mmHg in diabetics) in 2016–2017 b available for 362 patients in 2011-2013 and 383 patients in 2016-2017

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