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Sökning: id:"swepub:oai:DiVA.org:lnu-92858" > Preventable clinica...

Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population

Sverre, E. (författare)
Drammen Hosp, Norway;Univ Oslo, Norway
Peersen, K. (författare)
Vestfold Hosp, Norway
Weedon-Fekjaer, H. (författare)
Oslo Univ Hosp, Norway
visa fler...
Perk, Joep, 1945- (författare)
Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV)
Gjertsen, E. (författare)
Drammen Hosp, Norway
Husebye, E. (författare)
Drammen Hosp, Norway
Gullestad, L. (författare)
Univ Oslo, Norway;Oslo Univ Hosp Rikshosp, Norway;Oslo Univ Hosp Ulleval, Norway
Dammen, T. (författare)
Univ Oslo, Norway
Otterstad, J. E. (författare)
Vestfold Hosp, Norway
Munkhaugen, J. (författare)
Drammen Hosp, Norway;Univ Oslo, Norway
visa färre...
 (creator_code:org_t)
2020-02-05
2020
Engelska.
Ingår i: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 20:1, s. 1-9
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients' needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice. Methods This prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2-36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event. Results During a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes. Conclusions Coronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Coronary heart disease
Secondary prevention
Risk factors
Psychosocial factors
Prognosis
Recurrent cardiovascular events
Health and Caring Sciences
Hälsovetenskap

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