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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005333naa a2200433 4500
001oai:DiVA.org:uu-441365
003SwePub
008210506s2021 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:146192614
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4413652 URI
0247 a https://doi.org/10.1001/jamanetworkopen.2021.11292 DOI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1461926142 URI
040 a (SwePub)uud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Ohm, Joelu Karolinska Institutet4 aut
2451 0a Association of Socioeconomic Status With Risk Factor Target Achievements and Use of Secondary Prevention After Myocardial Infarction
264 c 2021-03-10
264 1b American Medical Association (AMA),c 2021
338 a print2 rdacarrier
520 a IMPORTANCE Low socioeconomic status (SES) is associated with poor long-term prognosis after myocardial infarction (MI). Plausible underlying mechanisms have received limited study. OBJECTIVE To assess whether SES is associated with risk factor target achievements or with riskmodifying activities, including cardiac rehabilitation programs, monitoring, and drug therapies, during the first year after MI. DESIGN, SETTING, AND PARTICIPANTS This cohort study included a population-based consecutive sample of 30 191 one-year survivors of first-ever MI who were 18 to 76 years of age, resided in the general community in Sweden, were followed up until their routine 11- to 15-month revisit, and were registered in the national registry SwedishWeb-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) from 2006 through 2013. Data analyses were performed from January to August 2020. EXPOSURE Individual-level SES by proxy disposable income quintile. Secondary exposures were educational level and marital status. MAIN OUTCOMES AND MEASURES Odds ratios (ORs) with 95% CIs for achieved risk factor targets at the 1-year revisit and for use of guideline-recommended secondary prevention activities. RESULTS The study comprised 30 191 participants ( 72.9% men) with a mean (SD) age of 63.0 (8.6) years. Overall, higher SESwas associated with better target achievements and use of most secondary prevention. The highest (vs lowest) income quintilewas associated with achieved smoking cessation (OR, 2.05; 95% CI, 1.78-2.35), target blood pressure levels (OR, 1.17; 95% CI, 1.07-1.27), and glycated hemoglobin levels (OR, 1.57; 95% CI, 1.19-2.06). The highest-income quintile was associated not only with participation in physical training programs (OR, 2.28; 95% CI, 2.11-2.46) and patient educational sessions (OR, 2.29; 95% CI, 2.12-2.47) in cardiac rehabilitation but also with more monitoring of lipid profiles (OR, 1.20; 95% CI, 1.08-1.33) and intensification of statin therapy (OR, 1.22; 95% CI, 1.11-1.35) during the first year after MI. One year after MI, the highest-income quintile was associated with persistent use of statins (OR, 1.26; 95% CI, 1.10-1.45), high-intensity statins (OR, 1.10; 95% CI, 1.00-1.21), and renin-angiotensin-aldosterone system inhibitors (OR, 1.27; 95% CI, 1.08-1.49). CONCLUSIONS AND RELEVANCE Findings indicated that, in a publicly financed health care system, higher SES was associated with better achievement of most risk factor targets, programs aimed at lifestyle change, and evidence-based drug therapies after MI. Observed differences in secondary prevention activity may be a factor in higher long-term risk of recurrent disease among individuals with low SES.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a CORONARY-HEART-DISEASE; CARDIAC REHABILITATION; CARDIOVASCULAR-DISEASE; SMOKING-CESSATION; EUROPEAN-SOCIETY; CHALLENGES; CARDIOLOGY; ACCESS
7001 a Skoglund, Per H.u Karolinska Institutet4 aut
7001 a Habel, Henrikeu Karolinska Inst, Inst Environm Med, Unit Biostat, Stockholm, Sweden.4 aut
7001 a Sundström, Johan,c Professor,d 1971-u Uppsala universitet,Geriatrik,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Molekylär epidemiologi,Science for Life Laboratory, SciLifeLab,Klinisk epidemiologi4 aut0 (Swepub:uu)johasund
7001 a Hambraeus, Kristinau Falun Cent Hosp, Dept Cardiol, Falun, Sweden.4 aut
7001 a Jernberg, Tomasu Karolinska Institutet4 aut
7001 a Svensson, Peru Karolinska Institutet4 aut
7102 a Karolinska Institutetb Karolinska Inst, Inst Environm Med, Unit Biostat, Stockholm, Sweden.4 org
7730 t JAMA Network Opend : American Medical Association (AMA)g 4:3q 4:3x 2574-3805
8564 u https://doi.org/10.1001/jamanetworkopen.2021.1129y Fulltext
8564 u https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2777316/ohm_2021_oi_210057_1614704378.00401.pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-441365
8564 8u https://doi.org/10.1001/jamanetworkopen.2021.1129
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:146192614

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