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心脏康复对前壁心肌梗死后左心室室壁瘤形成患者的预测作用(GRACE研究):一项前瞻性随机对照试验的研究原理与设计

The proGnostic role of caRdiac rehAbilitation in patients with left ventriCular anEurysm formation after anterior myocardial infarction (the GRACE study): Study rationale and design of a prospective randomized controlled trial.

作者信息

Zhang Peng, Ge Xiaofeng, Li Zhaokai, Nie Meiling, Yu Jing, Ou Weimei, Wu Kaimin, Li Jiahua, Wang Lin, Ni Wei, Shi Zaixing, Song Juan, Li Suiji, Dai Cuilian

机构信息

Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.

出版信息

Front Cardiovasc Med. 2023 Jan 10;9:991521. doi: 10.3389/fcvm.2022.991521. eCollection 2022.

Abstract

BACKGROUND

Cardiac rehabilitation (CR) is an essential intervention after acute myocardial infarction (MI). However, it is still unclear whether patients with left ventricular aneurysm (LVA) formation after anterior MI would benefit from CR programs. This clinical trial is designed to assess the role of CR in patients with LVA formation after anterior MI.

TRIAL DESIGN

The GRACE study is a single-center, single-blind, prospective, randomized controlled clinical trial in China. 100 subjects aged 18-75 years with LVA formation after anterior MI will be recruited and randomized 1:1 to the CR or control group. Both groups will receive standard drug treatment and routine health education according to the guidelines. Participants in the CR group will additionally receive tailored CR programs delivered over a period of 36 sessions. These participants will then be followed up for 1-year. The primary outcome is peak oxygen uptake measured by cardiopulmonary exercise testing after CR programs. The secondary outcomes are cardiac function and EuroQol 5-Dimension-3 Level index scores after CR program and 1-year and major adverse cardiac cerebrovascular events, a composite of cardiovascular mortality, non-fatal MI, non-fatal stroke, malignant arrhythmia or hospitalization for heart failure during the follow-up period.

CONCLUSIONS

This single-center, single-blind, prospective, randomized controlled clinical trial will determine whether CR improves physical capacity and clinical outcomes in patients with LVA formation after anterior MI.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200058852. Registered on 18 April 2022.

摘要

背景

心脏康复(CR)是急性心肌梗死(MI)后的一项重要干预措施。然而,前壁心肌梗死后形成左心室室壁瘤(LVA)的患者是否能从心脏康复计划中获益仍不清楚。本临床试验旨在评估心脏康复在前壁心肌梗死后形成左心室室壁瘤患者中的作用。

试验设计

GRACE研究是一项在中国进行的单中心、单盲、前瞻性、随机对照临床试验。将招募100名年龄在18 - 75岁、前壁心肌梗死后形成左心室室壁瘤的受试者,并按1:1随机分为心脏康复组或对照组。两组都将根据指南接受标准药物治疗和常规健康教育。心脏康复组的参与者还将额外接受为期36节的定制心脏康复计划。然后对这些参与者进行1年的随访。主要结局是心脏康复计划后通过心肺运动试验测量的峰值摄氧量。次要结局是心脏康复计划后、1年后的心脏功能和欧洲五维健康量表3级指数评分,以及随访期间的主要不良心脑血管事件,包括心血管死亡、非致命性心肌梗死、非致命性卒中、恶性心律失常或因心力衰竭住院的综合情况。

结论

这项单中心、单盲、前瞻性、随机对照临床试验将确定心脏康复是否能改善前壁心肌梗死后形成左心室室壁瘤患者的身体能力和临床结局。

试验注册

中国临床试验注册中心ChiCTR2200058852。于2022年4月18日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd9d/9871449/846411576820/fcvm-09-991521-g0001.jpg

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