09 June 2025 : Clinical Research
Self-Management-Centric Cardiac Rehabilitation for Acute Coronary Syndrome Patients During the COVID-19 Pandemic
Yiwen Wang ABCE 1, Haowen Shi BCEF 1, Min Zhang BDF 1, Yang Duan D 1, Zhi Li BDF 1, Lei Chen BCD 1, Yixuan Wu BCF 1, Yanfei Ren BF 1, Yuan Lu ADEG 1*DOI: 10.12659/MSM.947235
Med Sci Monit 2025; 31:e947235
Table 1 Primary and secondary outcomes and measurements.
| Outcomes | Target | Measurements | Intervention |
|---|---|---|---|
| Cardiovascular-related mortality | Avoidance | Self-reported and hospital records (Death attributable to cardiovascular causes, including myocardial infarction, heart failure, arrhythmias, or stroke, as confirmed by medical records or death certificates) | |
| Non-fatal myocardial infarction | Avoidance | Hospital records (Diagnosis of myocardial infarction based on clinical symptoms, electrocardiographic changes, and elevated cardiac biomarkers (e.g., troponin levels), as per the Fourth Universal Definition of Myocardial Infarction) | |
| Unplanned revascularization | Avoidance | Hospital records (Unplanned percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) performed due to recurrent ischemia or progression of coronary artery disease) | |
| Heart failure readmission | Avoidance | Hospital records (requiring oxygen substitution and/or intravenous therapies, such as diuretics and inotropes). Readmission within 24 hours will not be counted as a new event | |
| Non-fatal stroke | Avoidance | Examination image and hospital records (Acute neurological deficit lasting >24 hours, confirmed by imaging (CT or MRI) and classified as ischemic or hemorrhagic stroke, including transient ischemic attack) | |
| Self-perception of disease | Maximum score up to 20 points | CADEQ-SV (a true/false/I do not know questionnaire, with 20 items (4 in each domain) | Exercise/Risk factors/Dietary advice/Medication education/Psychosocial advice |
| Medication adherence | Maximum adherence to treatmentMaximum score up to 8 points | Self-reported, follow-up recordsMedication Possession Ratio | Educate about disease and medicationsEducate about symptom management |
| Exercise adherence | Physical activity ≥30 min/day corresponding a brisk walkModerate aerobic activity ≥30 min for 5 days/week (12–16 at Borg’s scale). Warm-up and cool down. | Self-reported intensity, frequency and duration | Educate on exercise safety, benefits, and components of exerciseIndividualized exercise prescription |
| Smoking status | Smoking cessationNo exposure to tobacco in any form | Active smoker yes/noSelf-reported number of cigarettes | Educate about benefits of smoking cessation Assist and refer when needed |
| BP management | BP <140/90 mmHg, or <130/80 mmHg (for diabetes) Higher target allowed in frail elderly; Heart rate 55–60 bpm | Self-reported and follow-up records | Educate about harm of hypertension |
| Weight management | Target BMI 20–25 kg/m | Self-reported weight (kg) and height (m) | Educate about effective weight losing according to diet, exercise |
| Lipid profile | LDL-C <1.4 mmol/L and a reduction of at least 50% | Standard laboratory assessment | Educate about benefits of lowing lipid and its harm of hyperlipidaemia |
| Diabetes management | HbA1c <7% | Standard laboratory assessment | Educate about harm of diabetes |