Article

Evaluation of one year outcome of an individualized program of ambulatory cardiac rehabilitation and interventions of secondary prevention after elective PTCA. Methods and results According to personalization of cardiac rehabilitation and restenosis evaluation, three degrees of intervention in 256 patients were performed. During one year follow-up, two patients died (sudden death). Within 6 months, 84 (32%) experienced angina and 53 (20.8%) between 6 and 12 months. In total, 60 patients required repeated coronary angiography of which 42 underwent re-PTCA. At one year follow-up, total serum cholesterol diminished from 209 40 to 195 +/- 49mg/dl (P=0.0004) and LDL-cholesterol from 137 +/- 36 to 119 +/- 31 mg/dl (P<0.0001). HDL-cholesterol increased from 43 +/- 11 to 47 +/- 12mg/dl
(P<0.0001) whereas smokers diminished from 92 to 8 (36.2% vs 3.1%). Systolic blood pressure diminished from 140 +/- 22 to 135 +/- 12 mmHg (P < 0.0001). Before PTCA, 53% of patients were physically very active and increased to 67% after one year (P=0.008). Weight increased from 77.9 to 78.5 (P=0.015). There were no significant variations in glycaemia (diabetic patients). After 6 months, 50 out of 64 working patients (78%) returned to work. Anxiety, depression and quality of life (SF-36) scores showed a greater improvement in mates. The mean costs of three degrees of intervention were : (1) extensive: EURO 1085.50 ; (2) short: EURO 836.40; (3) without exercise training: EURO 246.90. Conclusions The present results indicate that, after PTCA, ambulatory cardiac rehabilitation with individualized care approach is safe and not expensive. After one year, the risk factor levels improved significantly except glycaemia in diabetics and weight. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Langue : ANGLAIS

Tiré à part : OUI