Analysis Of The Control Of Risk Factors And Influence By Cardiac Rehabilitation Program In Patients After PCI

Objective1. The situation of secondary prevention was shown by this study,through the investigation of risk factors and evidence-based medicine of coronary heart disease patients with coronary artery disease underwent PCI,provide the theory basis for the intervention of the future clinical work,minimize thegap between evidence.based medicine and clinical practice,enhance the effect of secondary prevention.2. Through the study of the influence on reducing blood lipid and improving the quality of life in patients after PCI by cardiac rehabilitation, this study provide theory basis for standardized management in patients after PCI.Methods1. To collect the data of 100 cases in our hospital between Deceber,2011-January 2013 who were confirmed as coronary artery disease by coronary angiography after their first percutaneous coronary intervention. We use the self-designed questionnaires to know about their demographic, medication status and underwent risk factor assessment and to investigate the awareness rate of risk factors, the presence control of risk factors and drug use rate.2. Accoring to the characteristics and features of the patients after PCI, then selected a total of 68 patients after PCI who were randomised to a comprehensive intervention programme(IP) or to usual care(UC). Both groups were given the same comprehensive medication. Participants in IP were invited to undertaken the cardiac rehabilitation. After a period of 12 months of intervention, we compared statistical indicators of their demographic, medication status and underwent risk factor assessment, quality of life between these two group.3. Statistics analyses used SPSS 11.0 statistical software, data Meeting the normal distribution used x ± S, analysis between the two groups used independent samplet test; count data used a percentage, Test level of α = 0.05.Results1. Patients after with postoperative follow-up FB,postprandialblood glucose,TG LDL-C ratio was increased when compared to hospitalization,the difference Wasstatistically significant(P<0.05).There was no statistically difference in weight,BMI,systolic and diastolic pressure compared with admission.(P<O.05).2. When the patient was discharged taking aspirin, plavix,lipid-lowering statin drugs,β-blockers,angiotensin-converting enzyme inhibitors(ACEI)/angiotensin II receptor blockers(ARB)proportions were100%、100%、100%、100%、98%,while the follow—up of various types of drug use rates were 92%、82%、66%、60%、57%.Among statin lipid-lowering drugs,B-blockers,ACEI/ARB taking rate has dropped significantly, and the difference was statistically significant(P<O.05).3. After a period of 6 months and 12 months intervention, BMI,diastolic bloodpressure between the two groups had no significant difference(P > 0.05);After aperiod of 6 months and 12 months intervention,the difference between this twogroup of HDL-C, TC/, HDL-C, systolic blood pressure,smoking rates werestatistically(P < 0.01); After a period of 6 months and 12 months intervention, thedifference between this two group of TC, TG, LDL-C,fasting bloodglucose,glycosylated hemoglobin and there was statistical difference(P < 0.05).4. The myocardial infarction rate between the two groups had no statistical significance(P>0.05); The incidence of myocardial infarction, revascularization(including again PCI or CABG),unstable angina,congestive heart failure of IP were significantly lower than those in the UC, there were statistically significant(P < 0.005); The cardiac mortality of IP was lower than that of UC(P < 0.05).5. after a period of 1 year of intervention, There was no significant difference in using aspirin, clopidogrel,statins rate(P > 0.05).The beta blocker medication using rate of IP was significantly higher than that of UC,the difference was statistically significant(P < 0.001);.The ACEI/ARB using rate of IP was significantly higher than that of UC,the difference was statistically significant(P < 0.05).6. After a period of 1 year intervention, the quality of life score of two of each group increased,the IP’s quality of life score was significantly higher than the UC,the difference was statistically significant(P = 0.0135).7. After a period of 1 year intervention,the 6minute walking distance of two of each group was further than that of one week,the difference was statistically significant(P < 0.05). The 6 minute walkingdistance of IP was further than that of UC after one year intervention,the difference was statistically significant(P < 0.05).Conclusion1. Patients after PCI cannot control the risk factors of coronary heart disease well.2. Most of patients after PCI can follow doctor medication,but the rate of medication declined.The statin drugs and B receptor blocker, ACEI/ARB use rate decreased significantly.3. Compared with usual care, comprehensive health intervention seems a more effective way to control the risk factors of coronary heart disease, improve and the quality of life,increase the rate of drug use and reduce adverse cardiac event rate in patients after PCI.