Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Karageorgiou Sofia
Dissertation committee:
Σπυρίδων Δευτεραίος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευστάθιος Ηλιοδρομίτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Φιλιππάτος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Παρίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιγνάτιος Οικονομίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνα Αγγέλη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Επίδραση της εφαρμογής προγράμματος εκπαίδευσης ενηλίκων σχετικά με την τροποποίηση παραγόντων καρδιαγγειακού κινδύνου στη μεσοπρόθεσμη επίπτωση καρδιαγγειακών συμβαμάτων σε μετεμφραγματικούς ασθενείς
Translated title:
Effect of an adult education programme regarding lifestyle modification on the midterm prognosis of post-myocardial-infarction patients
Summary:
Background: Acute myocardial infarction (MI) is one of the major clinical manifestations of coronary artery disease. Post-MI morbidity and mortality can be prevented by lifestyle changes and aggressive risk factor modification. These changes can be more effectively applied if the patient is actively involved in the process. The hypothesis of the present prospective randomized study was that an educational program in post-MI patients could lead to reduced incidence of cardiovascular events.
Methods: Post-MI patients were randomized into two groups. Patients in the intervention arm were scheduled to attend an 8-week-long educational program on top of usual treatment, while controls received optimal treatment. The primary endpoint was the composite of all-cause death, MI, cerebrovascular event and unscheduled hospitalization for cardiovascular causes. Endpoint adjudication was blinded.
Results: 329 patients were included, 168 in the intervention arm and 161 in the control arm. Over a follow-up time of 17±4 months, the raw rates of the primary endpoint were 20.8% (6 deaths, 13 MIs, 2 strokes and 14 hospitalizations) versus 36.6% (8 deaths, 22 MIs, 7 strokes and 22 hospitalizations), respectively (odds ratio 0.46, 95% confidence interval 0.28-0.74; p=0.002). In the prespecified primary analysis, mean primary-event-free survival time was 597 days (95% confidence interval 571-624) in controls, as compared to 663 days (95% confidence interval 638-687) in the intervention group (p<0.001). The hazard ratio in the univariate Cox regression analysis was 0.48 (95% confidence interval 0.32-0.73; p=0.001).
Conclusion: The results of the present prospective randomized study indicate that a relatively short adult education program offered to post-MI patients has beneficial effects, resulting in reduced risk of cardiovascular events.
Main subject category:
Health Sciences
Keywords:
Myocardial infarction, Education, Secondary prevention, Lifestyle modification
