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Myocardial Infarcti...
Myocardial Infarction with Non-Obstructive Coronary Arteries : The Importance of Achieving Secondary Prevention Targets
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- Eggers, Kai M., 1962- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Hadziosmanovic, Nermin (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Baron, Tomasz (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Hambraeus, K. (author)
- Department of Cardiology, Falun Hospital, Falun, Sweden
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- Jernberg, T. (author)
- Karolinska Institutet
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- Nordenskjöld, Anna M., 1977- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Faculty of Health, Department of Cardiology, Örebro University, Örebro, Sweden
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- Tornvall, P. (author)
- Karolinska Institutet
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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(creator_code:org_t)
- Elsevier, 2018
- 2018
- English.
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In: American Journal of Medicine. - : Elsevier. - 0002-9343 .- 1555-7162. ; 131:5, s. 524-531
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Around 5-10% of all myocardial infarction patients have non-obstructive coronary arteries. Studies investigating the importance of follow-up and achievement of conventional secondary prevention targets in these patients are lacking.METHODS: In this analysis from the SWEDEHEART registry, we investigated 5830 myocardial infarction patients with non-obstructive coronary arteries (group 1) and 54,637 myocardial infarction patients with significant coronary artery disease (≥50% stenosis; group 2). Multivariable- and propensity score-adjusted statistics were used to assess the reduction in the one-year risk of major adverse events associated with prespecified secondary preventive measures: participation in follow-up at 6-10 weeks after the hospitalization; achievement of secondary prevention targets (blood pressure and low-density lipoprotein cholesterol levels in the target ranges, non-smoking, participation in exercise training).RESULTS: Patients in group 1 were less often followed up compared to patients in group 2 and less often achieved any of the secondary prevention targets. Participation in the 6-10 week follow-up was associated with a 3-20% risk reduction in group 1, similar as for group 2 according to interaction analysis. The improvement in outcome in group 1 was mainly mediated by achieving target range low-density lipoprotein cholesterol levels (24-32% risk reduction) and, to a smaller extent, by participation in exercise training (10-23% risk reduction).CONCLUSIONS: Selected secondary preventive measures are associated with prognostic benefit in myocardial infarction patients with non-obstructive coronary arteries, in particular achieving target range low-density lipoprotein cholesterol levels. Our results indicate that these patients should receive similar follow-up as myocardial infarction patients with significant coronary stenoses.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Follow-up
- Myocardial infarction
- Myocardial infarction with non-obstructive coronary arteries
- Prognosis
- Secondary prevention
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Eggers, Kai M., ...
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Hadziosmanovic, ...
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Baron, Tomasz
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Hambraeus, K.
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Jernberg, T.
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Nordenskjöld, An ...
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show more...
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Tornvall, P.
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Lindahl, Bertil, ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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American Journal ...
- By the university
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Örebro University
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Uppsala University
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Karolinska Institutet