Exercise Tolerance and Its Influencing Factors in Patients with Stable Coronary Artery Disease under Standardized Community Management

Abstract

Background Patients with stable coronary artery disease (SCAD) have a high risk of atherosclerotic stenosis of the coronary arteries, plaque rupture and thrombosis, and a high probability of recurrent cardiovascular events, which is the essential cause of repeated hospitalization. Cardiac rehabilitation mainly based on exercise rehabilitation in developed countries leads to a significant decrease in the incidence, mortality, and readmission rates of cardiovascular disease in these countries and reduces medical costs. Objective To investigate exercise tolerance and its influencing factors in the standard management of SCAD patients in Department of General Practice, Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University, so as to provide a scientific basis for future cardiac rehabilitation in community. Methods In January 2020, a total of 980 SCAD patients with standardized management under the age of 75 years were searched in the community health information system (CHIS) (doctor workstation) of Department of General Practice, Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University by using cluster sampling method. Self-designed questionnaires [including tools such as the General Information Questionnaire and the Veterans Specific Activity Questionnaire (VSAQ) ] were used to investigate the patients. Based on the metabolic equivalents (METs) values measured by VSAQ, they were categorized into exercise tolerance≤7.0 METs group and exercise tolerance>7.0 METs group, and the differences in the clinical data of SCAD patients with different levels of exercise tolerance were compared. Logistic regression analysis was used to explore the factors influencing the exercise tolerance in SCAD patients. Results Among 980 patients with SCAD, 108 (11.0%) patients had exercise tolerance>7.0 METs, 619 (63.2%) had 5.0-7.0 METs, and 253 (25.8%) had<5.0 METs. Gender, age, PCI acceptance, prevalence of diabetes mellitus, blood pressure attainment, regular exercise, exercise intensity level, and exercise time per session of SCAD patients in the exercise tolerance≤7.0 METs group were compared with those in the exercise tolerance >7.0 METs group (P<0.05). Logistic regression analysis showed that gender, age, presence of diabetes, blood pressure attainment, regular exercise and exercise intensity were the influencing factors of exercise tolerance level in SCAD patients (P<0.05) . Conclusion SCAD Patients have exercise awareness, but their overall level of exercise tolerance is low (≤7.0 METs), with a lacking of exercise guidance. It is recommended to improve their quality of life by increasing their exercise tolerance level through exercise rehabilitation.

Keywords

• stable coronary artery disease|secondary prevention|exercise tolerance|cardiac rehabilitation|root cause analysis