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CHICAGO – Yoga-based cardiac rehabilitation appears to improve clinical outcomes in patients and can help IM patients resume normal activity, according to a site researcher.
In a multicenter randomized controlled trial, self-rated quality of life data showed improvements for the yoga-CaRe-based cardiac rehabilitation group from the beginning to the third month. For participants in Enhance Standard Care (ESC), there was an average change in the EVA-5D score of 9.2 (95% CI, 8.4-10.1), whereas the participants in the yoga care had a mean change of EVA-5D score of 10.7 (95% CI 9.9-11.5, P= 0.002 for both groups, "said Dorairaj Prabhakaran MD, deputy minister of the Public Health Foundation of India in New Delhi at the annual meeting of the American Heart Association (AHA).
Among the 1,989 participants in ESC, the main results were the delay before the first cardiac event occurred, consisting of 77 deaths, 15 non-fatal MIs, 3 non-fatal strokes and 59 emergency cardiac hospitalizations. . Among the 1,970 participants in yoga-CaRe, the same primary outcomes were measured as well as the occurrence of the first cardiac event, including 78 deaths, 13 non-fatal IDs, 5 non-fatal strokes and 48 emergency cardiovascular hospitalizations. he declared.
Cardiac rehab is a class I indication for patients after MI and has become a key aspect of cardiac care in high-income countries, Prabhakaran noted.
However, cardiac rehabilitation "is virtually non-existent" in low- and middle-income countries because of its high cost and the need for a multidisciplinary approach. Even in high-income countries, cardiac rehabilitation is usually only 25% to 35% of the time, as women and older patients tend to prefer simple and gender-sensitive approaches, Prabhakaran said. .
"In India, it is necessary to develop effective, inexpensive, culturally acceptable and culturally acceptable cardiac rehabilitation – a need that would be filled by yoga-CaRe if it were to be effective," he said. -he declares.
A 2015 review indicated that there was no randomized controlled trial of yoga outcomes related to cardiac events, death, and health-related quality of life. As a result, there is little information on the effectiveness of yoga in preventing certain coronary heart disease, highlighting the need for more research, said Vera Bittner, PhD in Theology of the University of California. Alabama in Birmingham.
"We can see the yoga-CaRe trial as a milestone in this area of research," said Bittner.
The researchers evaluated 3,959 patients (mean age 53.4 years). Of the ESC patients, 14.1% were women, as were 13.8% of yoga-CaRe patients.
Among ESC patients, 62.1% underwent revascularization, 98.5% used antiplatelet therapy, 83.5%, antiplatelet therapy, 49.4%, ACE inhibitors / Angiotensin II receptors (ARAs), 62.6% took beta-blockers and 93.2%, statins.
Of those who participated in yoga-CaRe, 60.7% underwent revascularization, 98.5% used antiplatelet therapy, 84.3% took a dual antiplatelet drug, 51.4% used ACE / ARA, 62 6% took beta-blockers and 93.2% took statins.
The Yoga-CaRe intervention consisted of an education on lifestyle, mediation and breathing; yoga session twice a week during weeks 5-7; full weekly yoga sessions during weeks 8 to 13; and yoga at home for weeks ≥14.
The ESC group received standard care: a brochure, delivered by the clinician individually or in a group, and three information sessions before discharge and at weeks 5 and 12.
For intention-to-treat analysis (ITT), the 3-month secondary results showed a change in EQ-5D-0.03 health status (95% CI-0.19-0.13. P= 0.72) for the unadjusted regression coefficient and return to daily activities prior to infarction 1.17 (95% CI: 0.11 to 2.23, P<0.001).
For the ITT analysis, the other 3-month secondary outcomes were the unadjusted odds ratio for health status (≤6) of 1.16 (95% C 1.01-1.34, P= 0.04), smoking cessation (OR 1.14, 95% CI 0.89-1.46, P= 0.11), and high drug compliance (OR 1.04, 0.91-1.19; P= 0.52).
"Yoga-CaRe has the potential to be an alternative to the conventional [cardiac rehab] programs and meet the unmet need for cardiac rehabilitation of patients in low- and middle-income countries, "said Prabhakaran.
Bittner highlighted the limitations of the study, including the inclusion of young patients and very few women, and the low rate of cardiovascular events in patients. In addition, ESC patients had fewer contacts with study staff than yoga patients.
She also noted that there was no exercise intervention for the ESC group, limited compliance among yoga participants and that there was no report on adverse events or injuries resulting from the yoga intervention.
Some of the future research questions to consider include how Yoga-CaRe compares to cardiac rehabilitation at the center or at home, or whether the program could be integrated with existing treatment protocols, Bittner said.
Prabhakaran announced his support for the Indian Council for Medical Research and the Council for Medical Research (UK).
Bittner has not revealed any relevant relationship with the industry.
2018-11-11T11: 00: 00-0500
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