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- Alm, Carin, et al.
(författare)
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Better knowledger improves adherence to lifestyle changes and medication in patients with coronary heart disease.
- 2004
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 3:4, s. 321-330
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients with coronary heart disease (CHD) are not managed adequately, and we often fail to reach treatment targets. Aim: To investigate if knowledge of risk factors for CHD, measured by a questionnaire, would show any relation to advice to compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. Method: Men and women <71 years who had had a cardiac event were screened consecutively (509) from the medical records. Responders (392) were interviewed, examined and received a questionnaire. Three hundred and forty-seven patients answered the questionnaire regarding their general knowledge of risk factors for CHD, compliance to lifestyle changes to attain treatment goals and adherence to drug therapy. Results: There were statistically significant correlations between general knowledge about risk factors for CHD and compliance to certain lifestyle changes: weight, physical activity, stress management, diet, attainment of lipid level goals and the likelihood of taking prescribed blood pressure-lowering drugs. General knowledge of risk factors had no correlation to blood glucose or blood pressure levels nor on smoking habits or treatment patterns for prescribed lipid- and blood glucose-lowering drugs. Conclusion: Knowledge correlates to patient behaviour with respect to some risk factors, which should be recognised in preventive programs.
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| 2. |
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| 3. |
- Stagmo, Martin, et al.
(författare)
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För få kranskärlspatienter får lipidsänkande behandling [Few patients with coronary diseases are receiving lipid-lowering therapy]
- 2002
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Ingår i: Läkartidningen. - 0023-7205. ; 99:16, s. 9-1802
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Tidskriftsartikel (refereegranskat)abstract
- I Sverige finns sedan flera år riktlinjer för hur förhöjda blodfetter bör behandlas hos patienter med kranskärlssjukdom. Generellt är intresset för och kunskapen om lipidbehandling stort inom den svenska läkarkåren. Trots detta nås uppsatta mål för behandling av blodfetter hos endast en minoritet av patienterna, och hälften av dem får inte någon farmakologisk lipidsänkande behandling, enligt en nyligen genomförd enkätundersökning. Det finns dessutom patientgrupper som i lägre grad än andra erbjuds behandling. Om fler patienter med hyperlipidemi och kranskärlssjukdom behandlas med lipidsänkande läkemedel i sådana doser att behandlingsmålen uppnås skulle sjukligheten i kranskärlssjukdom sannolikt minska ytterligare.
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| 4. |
- Stagmo, Martin, et al.
(författare)
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Long-term effects on cholesterol levels and the utilization of lipid-lowering drugs of a hospital based programme for seconadry prevention of coronary artery disease
- 2001
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - 1741-8275. ; 8:4, s. 243-248
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Tidskriftsartikel (refereegranskat)abstract
- Background: The study was designed to determine whether a 1-year hospital-based secondary prevention programme would have any long-term effects on serum lipid levels and the use of lipid-lowering drugs in patients with coronary artery disease 4 years after referral to primary care facilities for follow-up. Design/methods: After acute myocardial infarction or coronary bypass surgery, 241 consecutive patients were randomly assigned to conventional care (CC) by the primary health care facilities or to a 1-year hospital-based secondary prevention programme (SPP) with target levels for serum cholesterol (<5.2 mmol/l) and triglycerides (<1.5 mmol/l). After 1 year all patients were referred to the primary care sector for a further 4-year follow-up. Results: At the 1-year follow-up there was a significant decrease in serum cholesterol, LDL-cholesterol and triglyceride levels in the SPP group but no change in the CC group, and lipid-lowering drugs were used more frequently in the SPP group. These changes were maintained after 5 years. The proportion of patients achieving target serum cholesterol and triglyceride levels were larger in the SPP group. Conclusions: Initiatives regarding cholesterol lowering and drug treatment taken by specialists within a structured hospital-based SPP have long-term impact. Accordingly, drug treatment should be initiated and adjusted to adequate doses before patients are referred to primary care for follow-up.
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| 5. |
- Stagmo, Martin, et al.
(författare)
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The Swedish national programme for quality control of secondary prevention of coronary artery disease - Results after one year
- 2004
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - : Oxford University Press (OUP). - 1741-8267 .- 1741-8275. ; 11:1, s. 18-24
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Forskningsöversikt (refereegranskat)abstract
- Background: Guidelines for the prevention of coronary artery disease (CAD) have been developed both in Europe and in the USA. However, several surveys have shown that these guidelines are poorly implemented in clinical practice. Design/methods: The Swedish Quality Control Programme on Secondary Prevention of CAD includes patients after myocardial infarction, or having undergone coronary artery surgery or percutaneous coronary intervention. Fifty of Sweden's 79 hospital districts are currently participating. Patients are asked to send report-cards regarding risk factor management to a central registry after discharge from hospital, at a 3-6 month visit and then yearly for 5 years. Results: Results based on data from 1 year after the index event show that a majority of patients reach targets for serum cholesterol (70%), and low-density lipoprotein (LDL)-cholesterol (71%). Mean value for total cholesterol is 4.6 (± SD 0.9) mmol/l, LDL-cholesterol 2.7 (± SD 0.8) mmol/l. Blood pressure targets are less often achieved, with 58% reaching the European Society of Cardiology target for systolic (< 140 mmHg) and 81% for diastolic (< 90 mmHg) blood pressure. A large proportion of patients are prescribed preventive drugs: aspirin (96%), beta-blockers (78%) and lipid-lowering drugs (83%). Conclusions: The Swedish Quality Control Programme is one of the first attempts to assess implementation of guidelines on a national level based on patient participation. It is hoped that shared care programmes and increased patient involvement with feedback on achieved treatment goals in relation to guidelines will improve outcomes in patients with CAD. © 2004 The European Society of Cardiology.
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| 6. |
- Willenheimer, Ronnie, et al.
(författare)
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Echocardiographic assessment of left atrioventricular plane displacement as a complement to left ventricular regional wall motion evaluation in the detection of myocardial dysfunction.
- 2002
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Ingår i: International Journal of Cardiovascular Imaging. - 1875-8312. ; 18:3, s. 181-186
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Tidskriftsartikel (refereegranskat)abstract
- AIM: We aimed to find out if abnormal left atrioventricular plane displacement (AVPD) is a sign of myocardial dysfunction, even in patients with normal left ventricular (LV) regional wall motion (RWM). METHODS: We prospectively performed echocardiography in 1350 consecutive patients referred to our echocardiography laboratory. Left AVPD and LV RWM were evaluated in all patients. We prospectively selected all patients with normal LV RWM but impaired left AVPD for further analysis of clinical parameters. RESULTS: Eighty-eight of the 1350 patients had completely normal LV RWM but impaired left AVPD (< or = 10 mm) in at least one region (septal, lateral, posterior, anterior). Of these, 60.2% had prior and/ or acute myocardial infarction, predominantly non-Q-wave, whereas 33.0% had angina without infarction and 2.3% had hypertension. In 49 (55.7%) patients coronary angiography was performed. All were abnormal. In 4.5% (n = 4) of the patients no obvious reason for the AVPD decrease was found, but was not precluded. CONCLUSION: Almost all patients with abnormal left AVPD and completely normal LV RWM had clinical cardiac disease. Thus, decreased AVPD despite normal LV RWM seems to be a true sign of myocardial dysfunction, predominantly indicating subendocardial dysfunction. In screening for patients with myocardial dysfunction assessment of left AVPD may be useful as a complement to LV RWM evaluation. The prognosis in such patients is currently being evaluated.
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