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Sökning: L773:1774 024X > Linnéuniversitetet

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1.
  • Perk, Joep, et al. (författare)
  • Study of patient information after percutaneous coronary intervention (SPICI) : should prevention programmes become more effective?
  • 2015
  • Ingår i: EuroIntervention. - : EuroPCR. - 1774-024X .- 1969-6213. ; 10:11, s. e1-e7
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: This cross-sectional observational study was designed to evaluate the uptake and outcome of patient education after percutaneous coronary intervention (PCI).Methods and results: A questionnaire containing 41 items was handed out to consecutive patients from randomly selected Swedish hospitals after PCI. Questions concerned the patient's attribution of the cause of the cardiac event, perception of the information provided by physicians and nurses, and a self-assessment of changes in lifestyle post PCI regarding tobacco, physical activity, food habits and stress. Replies were obtained from 1,073 patients (reply rate 67%). Non-modifiable risk factors (age, heredity) were attributed a higher rate as the cause of disease compared to modifiable factors (smoking, physical activity, food habits). Most patients (67%) perceived they were cured, and 38% perceived from the given information that there was no need to change their habits. A mere 27% reported that they still had cardiovascular disease and needed behavioural change. After PCI, 16% continued to use tobacco; half of these were offered smoking cessation support. In spite of an 80% referral rate to cardiac rehabilitation, one out of two patients did not enrol. Fewer than half were regularly physically active. Nutritional counselling was provided to 71%, but only 40% changed food habits. Stress management programmes were rarely provided.Conclusions: Current preventive practice scarcely meets the challenge posed by the progress in modern invasive cardiology. The Study of Patient Information after percutaneous Coronary Intervention (SPICI) motivates an in-depth revision and adaptation of cardiac rehabilitation programmes in order to improve patient understanding of the disease, and to support greater compliance with a cardioprotective lifestyle.
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2.
  • Schwalm, Torsten, et al. (författare)
  • Current treatment and outcome of coronary in-stent restenosis in Sweden : a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
  • 2013
  • Ingår i: EuroIntervention. - 1774-024X .- 1969-6213. ; 9:5, s. 564-572
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The aim of this study was to evaluate treatment of coronary in-stent restenosis (ISR). Methods and results: We investigated interventions for ISR and the occurrence of re-restenosis in the Swedish Angiography and Angioplasty Registry (SCAAR). From January 1st 2005 to March 3rd 2012, 212,166 coronary segments were treated and 7,806 restenoses analysed. During seven years of follow-up 1,079 re-restenoses were registered on clinically driven angiography. For BMS-ISR the adjusted risk of re-restenosis was significantly lower with DES (adjusted hazard ratio [BR] 0.71,95% confidence interval [CI]: 0.61-0.82), tended to be lower with DEB (HR 0.84, 95% CI: 0.62-1.16), but higher with BMS (BR 1.24, 95% CI: 1.0-1.55) as compared to balloon angioplasty. For DES-ISR a new DES was associated with a significantly lower adjusted risk of re-restenosis (HR. 0.80, 95% CI: 0.66-0.99), and a similar but non-significant reduction with DEB (BR 0.86, 95% CI: 0.57-1.30) and BMS (BR 0.81, 95% CI: 0.53-1.24) compared to balloon angioplasty. For DES-ISR a DES with a different drug was not more effective than a DES with the same drug. Conclusions: ISR in BMS should be treated with DES or DEB while the optimal treatment of ISR in DES remains to be proven.
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