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Organizational and ...
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Michelsen, Halldora ÖgmundsdottirLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Helsingborg Hospital
(author)
Organizational and patient-level predictors for attaining key risk factor targets in cardiac rehabilitation after myocardial infarction: The Perfect-CR study.
- Article/chapterEnglish2023
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Numbers
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LIBRIS-ID:oai:gup.ub.gu.se/321855
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https://gup.ub.gu.se/publication/321855URI
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https://doi.org/10.1016/j.ijcard.2022.09.012DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-491187URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-193603URI
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https://lup.lub.lu.se/record/cea09bd9-4d73-4b62-b90f-f0a0c32a3b49URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:152426043URI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE) [2019-00365]; Swedish Heart and Lung Association [20190431]; Swedish Heart and Lung Patient Organization; Swedish Cardiology Society; Faculty of Medicine, Lund University, Sweden; Astra Zeneca; Amgen
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Benefits of cardiac rehabilitation (CR) programme components on attaining risk factor targets post-myocardial infarction (MI) and their predictive strength relative to patient characteristics remain unclear. We aimed to identify organizational and patient-level predictors of risk factor target attainment at one-year post-MI.In this observational study data on CR organization at 78 Swedish CR centres was collected and merged with patient-level registry data (n=7549). Orthogonal partial least squares discriminant analysis identified predictors (Variables of Importance for the Projection (VIP) values >0.8) of attaining low-density lipoprotein-cholesterol (LDL-C) <1.8mmol/L, blood pressure (BP) <140/90mmHg and smoking abstinence.The strongest predictors (VIP [95% CI]) for attaining LDL-C and BP targets were offering psychosocial management (2.14 [1.78-2.50]; 2.45 [1.91-2.99]), having a psychologist in the CR team (1.62 [1.36-1.87]; 2.05 [1.67-2.44]), extended opening hours (2.13 [2.00-2.27]; 1.50 [0.91-2.10]), adequate facilities (1.54 [0.91-2.18]; 1.89 [1.38-2.40]), and having a medical director (1.70 [0.91-2.48]; 1.46 [1.04-1.88]). The strongest patient-level predictors of attaining LDL-C and/or BP targets were low baseline LDL-C (3.95 [3.39-4.51]) and having no history of hypertension (2.93 [2.60-3.26]), respectively, followed by exercise-based CR participation (1.38 [0.66-2.10]; 1.46 [1.14-1.78]). For smoking abstinence, the strongest organizational predictor was varenicline being prescribed by CR physicians (1.88 [0.95-2.80]) and patient-level predictors were participation in exercise-based CR (2.47 [2.07-2.88]) and group education (1.92 [1.43-2-42]), and no cardiovascular disease history (2.13 [1.78-2.48]).We identified multiple CR organizational and patient-level predictors of attaining risk factor targets post-MI. These results may influence the future design of comprehensive CR programmes.
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Henriksson, PeterKarolinska Institute
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Wallert, JohnKarolinska Institutet,Karolinska Institute
(author)
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Bäck, Maria,1978Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska Univ Hosp Gothenburg, Sweden; Univ Gothenburg, Sweden,Sahlgrenska University Hospital,Sahlgrenska Academy(Swepub:gu)xbamar
(author)
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Sjölin, IngelaSkane Univ Hosp, Sweden,Skåne University Hospital(Swepub:lu)in6057sj
(author)
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Schlyter, MonaSkane Univ Hosp, Sweden,Skåne University Hospital
(author)
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Hagström, EmilUppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Sweden; Uppsala Univ, Sweden(Swepub:uu)emhag677
(author)
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Kiessling, AnnaKarolinska Institutet
(author)
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Held, Claes,1956-Uppsala University,Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala Univ, Sweden; Uppsala Univ, Sweden(Swepub:uu)clahe947
(author)
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Hag, EmmaCty Hosp Ryhov, Sweden,Ryhov County Hospital, Jönköping
(author)
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Nilsson, Lennart,1971-Linköping University,Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Klinisk genetik(Swepub:liu)lenni29
(author)
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Schiopu, AlexandruLund University,Lunds universitet,Institutionen för translationell medicin,Medicinska fakulteten,Department of Translational Medicine,Faculty of Medicine,Skåne University Hospital,George Emil Palade University of Medicine, Pharmacy, Science, and Technology(Swepub:lu)medf-asc
(author)
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Zaman, M JustinWest Suffolk Hosp, England,West Suffolk Hospital
(author)
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Leosdottir, MargretLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-mle
(author)
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Internmedicin - epidemiologiForskargrupper vid Lunds universitet
(creator_code:org_t)
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In:International journal of cardiology: Elsevier BV371, s. 40-481874-17540167-5273
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