Compared with stents, cardiac rehabilitation can improve the prognosis of chronic coronary heart disease! ? British study

Drug therapy is the cornerstone of treatment for chronic coronary syndromes, and there is increasing evidence questioning the benefit of coronary intervention (stenting) for these patients.

The Chinese Cardiac Rehabilitation and Secondary Prevention Guidelines emphasize that all heart disease patients are eligible for cardiac rehabilitation, including those who have undergone coronary artery bypass grafting, coronary intervention, and chronic stable angina. However, a study by Fuwai Hospital found that less than 40% of discharged patients were recommended to receive cardiac rehabilitation.

Recently, a British study published in the European Journal of Preventive Cardiology showed that exercise-based cardiac rehabilitation can improve patient prognosis compared with coronary intervention.

Using data from 18,383 patients with chronic coronary syndromes from the Global Health Research Network, the authors compared the effects of coronary intervention with cardiac rehabilitation, and the effects of coronary intervention plus cardiac rehabilitation with cardiac rehabilitation alone.

The study showed that after propensity score matching, cardiac rehabilitation reduced the 18-month all-cause mortality by 63% and the risk of rehospitalization by 71% compared with coronary intervention.

In addition, compared with patients who received cardiac rehabilitation alone, patients who received coronary intervention combined with cardiac rehabilitation were only associated with a lower incidence of heart failure, while there were no significant differences in all-cause mortality, rehospitalization, myocardial infarction, and stroke.

Regarding the effect of cardiac rehabilitation, previous meta-analysis showed that exercise-based cardiac rehabilitation reduced the risk of cardiovascular death, but did not reduce total mortality. In addition, the risk of myocardial infarction or revascularization was not significantly reduced. The population studied was still mainly composed of patients with a low risk after myocardial infarction or revascularization.

Source: China Circulation Magazine