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Associated Factors of Different Cardiac Rehabilitation Adherence Profiles Post-PCI: A Latent Profile Analysis
Xingrong He1, Jing Wang1, Lingyan Ye2
1School of Medicine, Lishui University, Lishui, Zhejiang, 323000, People's Republic of China.
Insights
Cardiac rehabilitation adherence after percutaneous coronary intervention (PCI) shows significant variation. Understanding patient profiles and associated factors is key to improving adherence for better outcomes.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Health Services Research
Background:
- Cardiac rehabilitation (CR) adherence is crucial for patients post-percutaneous coronary intervention (PCI).
- Identifying distinct adherence profiles can reveal heterogeneity in patient engagement.
- Sociodemographic and clinical factors may influence CR adherence patterns.
Purpose of the Study:
- To identify distinct in-hospital CR adherence profiles in patients after PCI.
- To explore clinical and sociodemographic factors associated with these CR adherence profiles.
Main Methods:
- Cross-sectional survey of 384 hospitalized patients undergoing Phase I CR post-PCI.
- Latent Profile Analysis (LPA) used to identify CR adherence profiles.
- Multinomial logistic regression analyzed factors associated with profile membership, including LDL-C and number of diseased vessels.
Main Results:
- Three CR adherence profiles were identified: Low (32.55%), Medium (44.01%), and High (23.44%).
- Profile membership was significantly associated with gender, living situation, income, distance, smartphone use, and LDL-C.
- Overall CR adherence was moderate-to-low with significant heterogeneity.
Conclusions:
- Distinct CR adherence profiles exist among post-PCI patients, indicating varied engagement levels.
- Sociodemographic and clinical factors are linked to these profiles, suggesting potential targets for intervention.
- Future longitudinal studies are needed to confirm these non-causal associations and develop tailored support strategies.
Objective:
This study aimed to identify distinct in-hospital cardiac rehabilitation (CR) adherence profiles and explore their associated clinical and sociodemographic factors among patients following percutaneous coronary intervention (PCI).
Methods:
A cross-sectional survey was conducted among patients undergoing Phase I cardiac rehabilitation following percutaneous coronary intervention (PCI) who were hospitalized in the cardiology department between June and July 2025 (n=384). Data were collected using a general information questionnaire and a treatment adherence questionnaire (Since the study population consisted of inpatients undergoing PCI followed by phase I cardiac rehabilitation, the dimension of follow-up compliance was excluded). LPA, a person-centered method that identifies unobserved subgroups (profiles) based on response patterns, was prespecified to classify CR adherence profiles. Multinomial logistic regression was performed to examine factors associated with profile membership. Clinical indicators (number of diseased vessels, LVEF, LDL-C, and serum creatinine) were included as candidate predictors; after LASSO selection, LDL-C and number of diseased vessels were retained and entered the final multinomial logistic regression model as continuous variables (original values).
Results:
Three distinct CR adherence profiles were identified: Low CR Adherence (125/384, 32.55%), Medium CR Adherence (169/384, 44.01%), and High CR Adherence (90/384, 23.44%). Profile membership was significantly associated with gender, living situation, family monthly income, residential distance, smartphone use/proficiency and LDL-C (P < 0.05).
Conclusion:
CR adherence among post-PCI patients was overall moderate-to-low, with substantial heterogeneity across adherence patterns. The associated sociodemographic and contextual factors may help inform profile-based, tailored support to improve CR adherence after PCI. Given the cross-sectional design, these associations are non-causal and should be validated in future multicenter longitudinal and intervention studies.
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