Continuous care on the prognosis of coronary heart disease after PCI: a Meta-analysis and systematic review

Coronary heart disease (CHD) remains one of the leading causes of morbidity and mortality worldwide. Percutaneous coronary intervention (PCI) is widely used to restore coronary perfusion and improve cardiac outcomes; however, post-procedural management plays a crucial role in ensuring long-term recovery and preventing recurrent cardiovascular events. Continuous nursing, as an extended and structured follow-up model after hospital discharge, may improve patients' quality of life, psychological well-being, and self-management ability. This meta-analysis aimed to evaluate the effect of continuous nursing on the prognosis and overall outcomes of patients with CHD after PCI.

A comprehensive search was conducted through PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM databases up to December 2023. Randomized controlled trials (RCTs) comparing continuous nursing with conventional care in CHD patients after PCI were included. Data were analyzed using STATA 15.1 software, and outcomes were summarized as standardized mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CI).

Fourteen RCTs involving 1,463 participants were included. Compared with conventional care, continuous nursing significantly improved quality of life (WMD = 12.34, 95% CI: 8.79-15.88, I² = 82.6%), Cardiac Self-Management Scale (CSMS) scores (WMD = 18.02, 95% CI: 13.47-22.57, I² = 95.9%), left ventricular ejection fraction (LVEF, WMD = 6.91, 95% CI: 6.04-7.77, I² = 0%), medication adherence (OR = 11.72, 95% CI: 5.62-24.42, I² = 0%), and nursing satisfaction (OR = 8.50, 95% CI: 3.50-20.63, I² = 0%). It also reduced left ventricular end-diastolic diameter (LVEDD, WMD = - 8.72, 95% CI: - 9.79 to - 7.64, I² = 0%), anxiety measured by the Self-Rating Anxiety Scale (SAS, WMD = - 7.58, 95% CI: - 10.96 to - 4.20, I² = 74.3%), depression measured by the Self-Rating Depression Scale (SDS, WMD = - 6.21, 95% CI: - 8.75 to - 3.68, I² = 71.2%), and adverse cardiovascular events (OR = 0.18, 95% CI: 0.09-0.36, I² = 0%). Subgroup analysis indicated that WeChat-based continuous nursing produced stronger effects than nurse-led interventions (CSMS: WMD = 24.48 vs. 12.51), which partially explained the observed heterogeneity.

Continuous care effectively improves quality of life, psychological status, cardiac function, and treatment compliance in patients with CHD following PCI. It also reduces anxiety, depression, and cardiovascular complications, thereby promoting better long-term prognosis. These findings support the clinical implementation of structured continuous nursing programs as a key component of comprehensive CHD management after PCI.