Factors affecting quality of life after percutaneous coronary intervention in elderly patients with coronary heart disease: effects of the cardiac rehabilitation nursing model

影响老年冠心病患者经皮冠状动脉介入治疗后生活质量的因素:心脏康复护理模式的影响

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Abstract

OBJECTIVE: To analyze factors influencing the quality of life (QoL) of elderly patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) and to evaluate the clinical value a cardiac rehabilitation nursing model. METHODS: This randomized controlled trial assigned 112 elderly PCI patients to a control group (routine care) or an observation group (cardiac rehabilitation model), both receiving 6-month interventions. Outcome indicators were then compared between the two original groups at preoperative, 7-day postoperative, and 6-month follow-up time points. The control group was further stratified by post-PCI QoL scores into good and poor QOL subgroups for multivariate analysis. RESULTS: Age, smoking, Self-Rating Depression Scale (SDS) score, and P-selectin glycoprotein ligand-1 were identified as independent risk factors for poor QoL (P < 0.05). The observation group demonstrated significantly higher QoL scores, greater improvement in 6-minute walking test, left ventricular ejection fraction, and subtype segment resolution at both 7-day and 6-month follow-ups (P < 0.05). For T-wave inversion and left ventricular end-diastolic dimension (LVEDd), the observation group showed significantly greater improvement in T-wave inversion and lower LVEDd at 6-month follow-up (P < 0.05). Greater reductions in Self-Rating Anxiety Scale and SDS scores and inflammatory markers were also observed in the observation group at both time points (P < 0.05). CONCLUSION: Age, smoking history, SDS scores, and PSGL-1 are key predictors of postoperative QoL. The cardiac rehabilitation nursing model significantly outperformed routine care by improving patients' QoL, psychological state, cardiac function, and inflammation.

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