目的:在这项研究中,一项系统评价和荟萃分析调查了非药物干预对接受经皮冠状动脉介入治疗(PCI)的冠心病患者的主要不良心脏事件(MACE)的影响。
方法:使用PubMed进行了文献检索,科克伦图书馆,EMBASE,截至2023年11月,护理和护理及相关健康文献数据库的累积指数。使用Cochrane偏差风险2.0工具评估偏差风险。使用R软件(版本4.3.2)计算效应大小和95%置信区间。
结果:18项随机研究,涉及2,898名参与者,包括在内。其中,有2,697名参与者的16项研究提供了定量数据。非药物干预(教育,锻炼,并且全面)显着降低了心绞痛的风险,心力衰竭,心肌梗塞,再狭窄,心血管相关的再入院,和心血管相关的死亡。亚组meta分析显示,联合干预措施可有效减少心肌梗死(MI)的发生,个人和团体干预对减少MACE的发生有显著影响。在持续七个月或更长时间的干预措施中,发生率下降了0.16倍,与心血管疾病相关的死亡率下降了0.44倍,显示持续7个月或更长时间的干预措施在降低MI和心血管疾病相关死亡率方面更有效.
结论:需要进一步的研究来评估这些干预措施在接受PCI的患者中的成本效益,并验证其短期和长期效果。本系统综述强调了非药物干预在降低MACE发生率方面的潜力,并强调了在该领域继续研究的重要性(PROSPERO注册号:CRD42023462690)。
OBJECTIVE: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
METHODS: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
RESULTS: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
CONCLUSIONS: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).