Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-04-03 Cooperative journals: 《中国全科医学》
Abstract： Background Heart rate variability（HRV）is commonly used to evaluate the short-term prognosis of coronary artery diseaseas a well-known non-invasive indicator of cardiac autonomic function. Percutaneous coronary intervention （PCI）is a commonly usedsuigical treatment of coronary artery disease，however，major adverse cardiac event（MACE）such as malignant arrhythmias and recurrent myocardial infarction are common after suigical treatment.Although dual antiplatelet therapy（DAPT） can reduce the occurrence of MACE to a certain extent，it is prone to be complicated with gastrointestinal bleeding，and unabletoconsistently improve the prognosis of PCI. Ocular acupuncture can effectively reduce the duration and frequency of chest pain，and exercise therapy can enhance the function of heart and blood vessels. The application of ocular acupuncture and exercise combination therapy（OAECT） after PCI remains to be explored. Objective To investigate the effect of OAECT on postoperative heart rate variability and prognosis of patients treated with PCI.Methods A total of32 CHDpatients after PCIwith moderate and low risk attending hospital of Chengdu University of Traditional Chinese Medicinewere selected and randomly divided into the OAECTgroup and drug treatment groupin a 1∶ 1 allocation ratio. Patients in the OAECT group received OAECTin addition toDAPT，patients inthe drug treatment groupreceived DAPTalone，patientsin both 2 groups completed the 2-week intervention.The data of patients was collectedas follows：（1）Baseline indicators：gender，age，height，weight， blood pressure，respiratory rate，intervalbetween onset and intervention，education level，occupation，severity of coronary artery disease，and number of underlying diseases.（2）Main indicators：HRVwithin 24h after PCIand on the day of the end of 2-week intervention，includingthestandard deviation of all normal to normalRR intervals（SDNN），standard deviation of all 5-minute RRintervals（SDANN），mean of the standarddeviation of all NN intervals for all 5-min segmentof24 hours（SDNN index），root mean square of difference between adjacent NN intervals（rMSSD），percent of NN50 in the total number ofNN intervals（PNN50），high frequency（HF），low frequency（LF）low frequency/high frequency（LF/HF） values. Prognosis at 2，4，and 8 weeks after the interventionassessed by MACE，including cardiac or all-cause deaths，malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation，severe heart failure，recurrent myocardial infarction，repeat PCIand chest pain recorded by telephone and outpatient consultations. （3）Secondary indicators：C-reactive protein（CRP），N-terminal pro B type natriuretic peptide（NT-proBNP），creatine kinase isoenzyme（CK-MB），high-sensitivity troponin I（hs-TnI）. （4）Safety indicators：The occurrenceof complications after PCIsuch as subcutaneous hematoma，skin lesions，muscle soreness，respiratory abnormalitiesand stroke，all the outcomeindicatorswere measured within 24 hours afterPCI and on the day of the endof 2-week intervention. Results There wasnosignificantdifference in LF/HF，SDNN，SDANN，SDNN index，LF、HF，RMSSDandPNN50between the 2 groups（ P>0.05）. There were significant differences in LF/HF，SDNNand SDANN（ P<0.05）.CRP was higher in the drugtreatment group than OAECTgroupafter 2 weeks（ P<0.05）；there was no significant difference in NT-proBNP，CK-MBand hs-TnIbetween the 2 groups（ P>0.05）. The incidence ratesof MACE and adverse reactionsin the OAECT groupwerelowerthan DAPT group（ P<0.05）. Conclusion OAECT is more effective than drug treatment in improving HRV witha lower incidence rate of MACE and better prognosis forpatients after PCI.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-09 Cooperative journals: 《中国全科医学》
Abstract：
Background HRV (heart rate variability), a well-known non-invasive indicator of cardiac autonomic nervous function, is often used to evaluate the short-term prognosis of coronary artery disease. PCI (percutaneous coronary intervention), a common surgical method for coronary artery disease, usually accompanies with MACE (major adverse cardiovascular events), such as malignant arrhythmias, recurrent myocardial infarction, and so on. Although DAPT (dual antiplatelet therapy) can reduce the occurrence of MACE to a certain extent, it is prone to be complicated with gastrointestinal bleeding, thus, it cannot consistently improve PCI outcomes. Ocular acupuncture can effectively reduce the duration and frequency of chest pain, and exercise therapy can enhance the function of heart and blood vessels. The application of ocular acupuncture and exercise combination therapy after PCI remains to be explored. Objective To investigate the effect of ocular acupuncture and exercise combination therapy (OAECT) on heart rate variability and prognosis of coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Methods 32 patients completed the 2-week intervention and pre-post examination. Participants were randomly assigned to receive either OAECT based on dual antiplatelet therapy (DAPT) or DAPT alone in a 1:1 allocation ratio, for two weeks. Autonomic nervous system function was assessed by heart rate variability (HRV) via a 24-hour dynamic electrocardiogram. Prognosis of PCI was evaluated by major adverse cardiac events recorded in a specially designed adverse effect diary. All outcomes were measured within 24 hours after燩CI and intraday immediately after爐he 2-week intervention. Results Statistical significance was noted in LF/HF (1.420.72, P=0.044), SDNN (118.6024.92, P=0.045), SDANN (107.6025.75, P=0.049), and CRP (4.063.70, P=0.047) between the two groups after intervention. The incidence of MACE was lower in the OAECT group (25%) compared to the DAPT group (75%) (P=0.016), and it was negatively associated with SDNN (t=-3.714, P=0.002), SDANN (t=-3.553, P=0.003), and LF/HF (t=-2.225, P=0.043). Conclusions燨AECT is more effective than DAPT in improving HRV and has a lower rate of MACE, as well as a better prognosis for爌atients after PCI.
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