| Objective: To investigate the effect of home-based cardiac rehabilitation exercise on the long-term prognosis of acute myocardial infarction patients treated with percutaneous coronary intervention.Methods: 106 patients with acute myocardial infarction and PCI from September 2017 to January 2018 were included in this study in Hebei General Hospital and randomly divided into the rehabilitation group and the control group.If there is no contraindication of rehabilitation,patients in the rehabilitation group will start cardiac rehabilitation in 24 hours after the interventional surgery.Self-monitoring exercise was started after discharge.The control group only engaged in daily life activities.After discharge,the patients were followed up by telephone once a week after discharge,with an average follow-up of 14 months.A total of 15 patients were lost.Related parameters of observation indexes:blood lipid(total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein cholesterol and apolipoprotein A1,apolipoprotein B),cardiac function index(left ventricular ejection fraction,left ventricular short axis reduced rate)and Ischemic events(Rehospitalization for recurrent acute myocardial infarction,unstable angina,cerebral infarction,peripheral vascular thrombosis).Results:1.The baseline: The rehabilitation group and the control group were divided into three subgroups according to the size of LVEF.In the LVEF?60% subgroup,the rehabilitation group was younger than the control group(49.2±10.3 VS 60.1±12.9 years),and the rehabilitation group had more smokers than the control group [8(72.7%)VS 5(31.3%)],the difference was statistically significant(P<0.05).But no statistically significant differences in other general conditions,basic diseases,coronary artery lesions,medication,cardiac function and lipid-related indicators.2.Baseline indexes of heart function and blood lipid were compared in each subgroup: There were statistically significant differences in high-density lipoprotein cholesterol in the LVEF>50% subgroup(1.00±0.23 VS 1.19±0.14 mmol/L,P=0.035),and there are no significant differences in other blood lipids and cardiac function indicators.3.Indexes of heart function and blood lipid were compared after 14 months: in the LVEF<50% subgroup,the improvement of total cholesterol,high-density lipoprotein cholesterol and apolipoprotein A1 in the rehabilitation group was significant compared with the control group(P<0.05).In the 50% LVEF<60% subgroup,total cholesterol,low-density lipoprotein cholesterol and apolipoprotein B rehabilitation group were significantly improved compared with the control group(P<0.05).The improvement of left ventricular ejection fraction and left ventricular short-axis shortening rate in the LVEF 60% subgroup was significant compared with the control group(P<0.05).In each subgroup,there was no significant difference in other indicators between the rehabilitation group and the control group.4.Ischemic events: in the 50%<LVEF?60% subgroup,the difference between the rehabilitation group and the control group was statistically significant(8.7% VS 35.0%,P=0.034).Conclusion: Home-based cardiac rehabilitation exercise has different effects on patients with different cardiac functions.Total cholesterol was decreased and HDL-C was increased in LVEF<50%.Total cholesterol and low density lipoprotein can be reduced in patients with 50%<LVEF?60%,and the incidence of ischemic events were reduced;In patients with LVEF 60%,left ventricular systolic function can be improved,thereby improving the long-term prognosis of patients. |
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