Τίτλος:
A stand-alone structured educational programme after myocardial
infarction: a randomised study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Acute myocardial infarction (MI) is a major clinical
manifestation of coronary artery disease. Post-MI morbidity and
mortality can be reduced by lifestyle changes and aggressive risk factor
modification. These changes can be applied more effectively if the
patient is actively involved in the process. The hypothesis of this
study was that an educational programme in post-MI patients could lead
to reduced incidence of cardiovascular events.
Methods Post-MI patients were prospectively randomised into two groups.
Patients in the intervention arm were scheduled to attend an 8-week-long
educational programme 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 hospitalisation for
cardiovascular causes. Endpoint adjudication was blinded.
Results 329 patients (238 men) were included, with a mean follow-up time
of 17 +/- 4 months. In the primary analysis, mean primary end point-free
survival time was 597 days (95% CI 571 to 624) in controls, compared
with 663 days (95% CI 638 to 687) in the intervention group (p<0.001).
The HR in the univariate Cox regression analysis was 0.48 (95% CI 0.32
to 0.73; p=0.001). The raw rates of the primary endpoint were 20.8% (6
deaths, 13 MIs, 2 strokes and 14 hospitalisations) vs 36.6% (8 deaths,
22 MIs, 7 strokes and 22 hospitalisations), respectively (OR 0.46, 95%
CI 0.28 to 0.74; p=0.002).
Conclusion These results suggest that a relatively short adult education
programme offered to post-MI patients has beneficial effects, resulting
in reduced risk of cardiovascular events.
Συγγραφείς:
Giannopoulos, Georgios
Karageorgiou, Sofia
Vrachatis, Dimitrios
and Anagnostopoulos, Ioannis
Kousta, Maria S.
Lakka, Eleni and
Giotaki, Sotiria
Raisakis, Konstantinos
Sianos, Georgios and
Toutouzas, Konstantinos
Cleman, Michael
Deftereos, Spyridon
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
myocardial infarction; cardiac rehabilitation; risk factors
DOI:
10.1136/heartjnl-2020-318414