Attending Heart School and long-term outcome after myocardial infarction: A decennial SWEDEHEART registry study

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Attending Heart School and long-term outcome after myocardial infarction : A decennial SWEDEHEART registry study

Wallert, John (author): Karolinska Institutet,Uppsala University,Karolinska Institute,Uppsala universitet,Klinisk psykologi i hälso- och sjukvård,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden

Olsson, Erik M. G., 1967- (author): Uppsala University,Uppsala universitet,Klinisk psykologi i hälso- och sjukvård

Pingel, Ronnie, 1978- (author): Uppsala University,Uppsala universitet,Statistiska institutionen

Norlund, Fredrika (author): Uppsala University,Uppsala universitet,Klinisk psykologi i hälso- och sjukvård

Leosdottir, Margret (author): Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Department of Cardiology, Skåne University Hospital and Department of Clinical Sciences Malmö, Lund University

Burell, Gunilla (author): Uppsala University,Uppsala universitet,Institutionen för folkhälso- och vårdvetenskap

Held, Claes, 1956- (author): Uppsala University,Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala University Hospital

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(creator_code:org_t)

2019-09-13
2020
English.
In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 27:2, s. 145-154

Related links:: https://academic.oup...; show more...; http://dx.doi.org/10...; https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: The Heart School is a standard component of cardiac rehabilitation after myocardial infarction in Sweden. The group-based educational intervention aims to improve modifiable risks, in turn reducing subsequent morbidity and mortality. However, an evaluation with respect to mortality is lacking.AIMS: Using linked population registries, we estimated the association of attending Heart School with both all-cause and cardiovascular mortality, two and five years after admission for first-time myocardial infarction.METHODS: Patients with first-time myocardial infarction (<75 years) were identified as consecutively registered in the nationwide heart registry, SWEDEHEART (2006-2015), with >99% complete follow-up in the Causes of Death registry for outcome events. Of 192,059 myocardial infarction admissions, 47,907 unique patients with first-time myocardial infarction surviving to the first cardiac rehabilitation visit constituted the study population. The exposure was attending Heart School at the first cardiac rehabilitation visit 6-10 weeks post-myocardial infarction. Data on socioeconomic status was acquired from Statistics Sweden. After multiple imputation, propensity score matching was performed. The association of exposure with mortality was estimated with Cox regression and survival curves.RESULTS: After matching, attending Heart School was associated (hazard ratio (95% confidence interval)) with a markedly lower risk of both all-cause (two-year hazard ratio = 0.53 (0.44-0.64); five-year hazard ratio = 0.62 (0.55-0.69)) and cardiovascular (0.50 (0.38-0.65); 0.57 (0.47-0.69)) mortality. The results were robust in several sensitivity analyses.CONCLUSIONS: Attending Heart School during cardiac rehabilitation is associated with almost halved all-cause and cardiovascular mortality after first-time myocardial infarction. The result warrants further investigation through adequately powered randomised trials.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Patient education
cardiac rehabilitation
cardiovascular disease
prognosis
secondary prevention
Cardiology
Kardiologi
Caring Sciences
Vårdvetenskap
cardiac rehabilitation
cardiovascular disease
Patient education
prognosis
secondary prevention

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ref (subject category)
art (subject category)

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