Impact of a comprehensive cardiac rehabilitation programme versus coronary revascularization in patients with stable angina pectoris: protocol for the PRO-FIT randomised controlled trial
Notice bibliographique
Résumé
Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): ZonMW: The Netherlands Organisation for Health Research and Development Background Stable angina pectoris (SAP) is a highly common condition. Despite optimal medical treatment (OMT) patients often remain symptomatic and at high risk for cardiovascular morbidity and mortality. In daily practice the standard treatment consists of OMT usually followed by an invasive strategy, consisting of coronary angiography and subsequent coronary revascularization. However, recent studies showed that these costly and invasive procedures do not result in superior effects on re-events and prognosis as compared to drug therapy alone in patients with SAP. On the other hand, the effect of lifestyle-related interventions on vascular function and the progression of atherosclerotic coronary artery disease is well-known. Yet, contemporary RCTs comparing lifestyle interventions with coronary revascularization in patients with SAP are lacking. Purpose To compare the impact of a 12-month cardiac rehabilitation (CR) programme versus a routinely applied invasive approach (including coronary angiography and subsequent coronary revascularization) on anginal complaints and cost-effectiveness in SAP patients. We hypothesize that CR is at least equally effective as an invasive approach. Methods 216 SAP patients with residual anginal complaints under OMT will be randomized to usual care or a 12-month CR intervention aiming at angina relief and sustainable behavioural change for long-lasting improvement in cardiovascular health. The CR programme consists of multiple lifestyle interventions including an exercise programme, a dietary intervention and a psychoeducation module with a stepped decline in guidance by health care professionals. Patients in the CR group will receive access to an online platform, a chatbot and a smartwatch enabling patients and professionals to monitor the progress and adherence to lifestyle advices. During the first 3 months patients will receive face to face guidance, the next 3 months will consist of telerehabilitation using the smartwatch with weekly video consulting and the last 6 months will be focussed on relapse prevention and guidance on demand. The primary outcome will be the quantity of anginal complaints (evaluated by the Seattle Angina Questionnaire-7) following the 12-month intervention. Secondary outcomes include cost-effectiveness, the ischemic threshold during exercise, cardiovascular events, exercise capacity, quality of life and psychosocial wellbeing. Future implications This will be the first study evaluating a comprehensive disease-specific multimodal lifestyle intervention as a primary treatment for patients with SAP. If proven successful this study will have a great impact on the daily care of these patients as coronary revascularizations can partly be replaced by a less invasive, less costly and better sustainable treatment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».