| アブストラクト | BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in women, but the role of rehabilitation after SCAD is unclear. METHODS: We designed a dedicated SCAD cardiac rehabilitation (SCAD-CR) program for our SCAD survivors at Vancouver General Hospital. This program encompasses a multidisciplinary approach including exercise rehabilitation, psychosocial counselling, dietary and cardiovascular disease education, and peer group support. Exercise and educational classes were scheduled weekly with a targeted participation of 6 months. Psychosocial counselling, mindful living sessions, social worker and psychiatry evaluations, and peer-group support were offered. RESULTS: We report our first consecutive cohort of 70 SCAD women who joined SCAD-CR from November 2011 to April 2015. The average age was 52.3 +/- 8.4 years. Mean participation duration was 12.4 +/- 10.5 weeks; 28 completed 6 months, 48 completed >/= 1 month. At entry, 44 (62.9%) had recurrent chest pains and average metabolic equivalents on exercise treadmill test was 10.1 +/- 3.3. At program exit, the proportion with recurrent chest pains was lower (37.1%) and average metabolic equivalents was higher 11.5 +/- 3.5 (both P < 0.001). There was a significant improvement in the STOP-D depression questionnaire, with mean scores of 13.0 +/- 1.4 before and 8.0 +/- 1.7 after the SCAD-CR (P = 0.046). Twenty (28.6%) social worker referrals and 19 (27.1%) psychiatry referrals were made. Mean follow-up was 3.8 +/- 2.9 years from the presenting SCAD event, and the major cardiac adverse event rate was 4.3%, lower than our non-SCAD-CR cohort (n = 145; 26.2%; P < 0.001). CONCLUSIONS: This is the first dedicated SCAD-CR program to address the unique exercise and psychosocial needs of SCAD survivors. Our program appears safe and beneficial in improving chest pain, exercise capacity, psychosocial well-being and cardiovascular events. |
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| ジャーナル名 | The Canadian journal of cardiology |
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| 投稿日 | 2016/3/1 |
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| 投稿者 | Chou, Annie Y; Prakash, Roshan; Rajala, Jennifer; Birnie, Taira; Isserow, Saul; Taylor, Carolyn M; Ignaszewski, Andrew; Chan, Sammy; Starovoytov, Andrew; Saw, Jacqueline |
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| 組織名 | Division of Cardiology, Vancouver General Hospital, University of British;Columbia, Vancouver, British Columbia, Canada.;Division of Cardiology, Royal Jubilee Hospital, Victoria, British Columbia,;Canada.;Division of Cardiology, St Paul's Hospital, University of British Columbia,;Vancouver, British Columbia, Canada.;Columbia, Vancouver, British Columbia, Canada. Electronic address:;jsaw@mail.ubc.ca. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/26923234/ |
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