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Socioeconomic inequity in incidence, outcomes and care for acute coronary syndrome: A systematic review. Int J Cardiol 2022; 356:19-29. [DOI: 10.1016/j.ijcard.2022.03.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/17/2022] [Accepted: 03/24/2022] [Indexed: 12/17/2022]
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Katz DA, Buchanan DM, Weg MWV, Faseru B, Horwitz PA, Jones PG, Spertus JA. Does outpatient cardiac rehabilitation help patients with acute myocardial infarction quit smoking? Prev Med 2019; 118:51-58. [PMID: 30316877 PMCID: PMC6322961 DOI: 10.1016/j.ypmed.2018.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/27/2018] [Accepted: 10/10/2018] [Indexed: 12/25/2022]
Abstract
Outpatient cardiac rehabilitation (OCR) reinforces patients' efforts to quit smoking, but the association between participation in OCR and long-term smoking status after acute myocardial infarction (AMI) is unknown. We studied hospitalized smokers with confirmed AMI from two multicenter prospective registries (PREMIER, from January 1, 2003, to June 28, 2004, and TRIUMPH, from April 11, 2005, to December 31, 2008) to describe the association of OCR participation with smoking cessation. Eligible patients smoked at least 1 cigarette per day on average in the 30 days prior to enrollment and completed 12-month follow-up (N = 1307). Structured interviews were completed on subjects at baseline and during follow-up. OCR participation and abstinence from smoking within the prior 30-days (30-day point prevalence abstinence, PPA) were self-reported. We constructed a propensity model of OCR participation based on 22 baseline sociodemographic and clinical characteristics, and constructed hierarchical modified Poisson regression models of 30-day PPA at 12 months after matching on the propensity for OCR participation (with clinical site treated as a random effect). Seventy-four percent of subjects were referred to OCR at hospital discharge, but only 36% participated during follow-up. At 12-month follow-up, 30-day PPA was 57% in OCR participants, compared to 41% in matched OCR non-participants. Participation in OCR was a significant predictor of 30-day PPA at 12 months (adjusted RR 1.38, 95% CI 1.20-1.57). In conclusion, smokers who participated in OCR were significantly more likely to abstain from smoking 12 months after AMI hospitalization.
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Affiliation(s)
- David A Katz
- University of Iowa Carver College of Medicine, Iowa City, IA, United States of America; Comprehensive Access & Delivery Research and Evaluation Center, Iowa City VA Medical Center, United States of America.
| | - Donna M Buchanan
- Saint Luke's Mid America Heart Institute, Kansas City, MO, United States of America; University of Missouri at Kansas City, Kansas City, MO, United States of America
| | - Mark W Vander Weg
- University of Iowa Carver College of Medicine, Iowa City, IA, United States of America; Comprehensive Access & Delivery Research and Evaluation Center, Iowa City VA Medical Center, United States of America
| | - Babalola Faseru
- University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Philip A Horwitz
- University of Iowa Carver College of Medicine, Iowa City, IA, United States of America
| | - Philip G Jones
- Saint Luke's Mid America Heart Institute, Kansas City, MO, United States of America
| | - John A Spertus
- Saint Luke's Mid America Heart Institute, Kansas City, MO, United States of America; University of Missouri at Kansas City, Kansas City, MO, United States of America
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Zhang Y, Cao H, Jiang P, Tang H. Cardiac rehabilitation in acute myocardial infarction patients after percutaneous coronary intervention: A community-based study. Medicine (Baltimore) 2018; 97:e9785. [PMID: 29465559 PMCID: PMC5841979 DOI: 10.1097/md.0000000000009785] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI). METHODS A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65). Cardiac function, a 6-minute walk distance, exercise time and steps, cardiovascular risk factors were monitored respectively and compared before and after the intervention of 2 groups. The software of EpiData 3.1 was used to input research data and SPSS16.0 was used for statistical analysis. RESULTS After a planned rehabilitation intervention, the rehabilitation group showed better results than the control group. The rehabilitation group had a significant improvement in recurrence angina and readmission (P < .01). Left ventricular ejection fraction (LVEF) of rehabilitation group showed improvement in phase II (t = 4.963, P < .01) and phase III (t = 11.802, P < .01), and the New York Heart Association (NYHA) classification was recovered within class II. There was a significant difference compared with before (Z = 7.238, P < .01). Six minutes walking distance, aerobic exercise time, and steps all achieved rehabilitation requirements in rehabilitation group in phase II and III, there existed distinct variation between 2 phases. Rehabilitation group had a better result in cardiovascular risk factors than control group (P < .05). CONCLUSION Community-based CR after PCI through simple but safe exercise methods can improve the AMI patient's living quality, which includes increasing cardiac ejection fraction, exercise tolerance, and physical status. It must be emphasized that the good result should be established by the foundation of close cooperation between cardiologists and general practitioners, also the importance of cooperation of patients and their families should not be ignored. The rehabilitation program we used is feasible, safe, and effective.
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Affiliation(s)
| | | | - Pin Jiang
- Department of General Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
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Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, van 't Hof A, Meindersma E, Bossano Prescott EI, González-Juanatey JR. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol 2016; 223:436-443. [DOI: 10.1016/j.ijcard.2016.08.120] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 12/14/2022]
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George SA, Bivens TB, Howden EJ, Saleem Y, Galbreath MM, Hendrickson D, Fu Q, Levine BD. The international POTS registry: Evaluating the efficacy of an exercise training intervention in a community setting. Heart Rhythm 2016; 13:943-50. [DOI: 10.1016/j.hrthm.2015.12.012] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Indexed: 01/22/2023]
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Gallagher J, Parenti G, Doyle F. Psychological Aspects of Cardiac Care and Rehabilitation: Time to Wake Up to Sleep? Curr Cardiol Rep 2015; 17:111. [DOI: 10.1007/s11886-015-0667-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Pogosova N, Saner H, Pedersen SS, Cupples ME, McGee H, Höfer S, Doyle F, Schmid JP, von Känel R. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol 2014; 22:1290-306. [PMID: 25059929 DOI: 10.1177/2047487314543075] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/20/2014] [Indexed: 12/18/2022]
Abstract
A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.
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Affiliation(s)
- Nana Pogosova
- Federal Health Center and Department of Internal Disease Prevention, National Research Center for Preventive Medicine, Russia
| | - Hugo Saner
- Cardiovascular Prevention, Rehabilitation and Sports Medicine, Bern University Hospital, Switzerland
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Denmark Department of Cardiology, Odense University Hospital, Denmark
| | - Margaret E Cupples
- UKCRC Centre of Excellence for Public Health (Northern Ireland), Queen's University, Belfast, UK
| | - Hannah McGee
- Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, Ireland
| | - Stefan Höfer
- Medical Psychology, Innsbruck Medical University, Austria
| | - Frank Doyle
- Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, Ireland
| | - Jean-Paul Schmid
- Cardiology Clinic, Tiefenauspital, Bern University Hospital, Switzerland
| | - Roland von Känel
- Department of Neurology, Bern University Hospital, Switzerland Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
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Abstract
Cardiovascular disease (CVD) is the most-prevalent noncommunicable disease and leading cause of death globally. Over 80% of deaths from CVD occur in low-income and middle-income countries (LMICs). To limit the socioeconomic impact of CVD, a comprehensive approach to health care is needed. Cardiac rehabilitation delivers a cost-effective and structured exercise, education, and risk reduction programme, which can reduce mortality by up to 25% in addition to improving a patient's functional capacity and lowering rehospitalization rates. Despite these benefits and recommendations in clinical practice guidelines, cardiac rehabilitation programmes are grossly under-used compared with revascularization or medical therapy for patients with CVD. Worldwide, only 38.8% of countries have cardiac rehabilitation programmes. Specifically, 68.0% of high-income and 23% of LMICs (8.3% for low-income and 28.2% for middle-income countries) offer cardiac rehabilitation programmes to patients with CVD. Cardiac rehabilitation density estimates range from one programme per 0.1 to 6.4 million inhabitants. Multilevel strategies to augment cardiac rehabilitation capacity and availability at national and international levels, such as supportive public health policies, systematic referral strategies, and alternative models of delivery are needed.
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Affiliation(s)
- Karam Turk-Adawi
- Cardiovascular Rehabilitation &Prevention, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Seddigheh Tahereh Research and Treatment Hospital, Khorram Ave, PO Box 81465-1148, Isfahan, Iran
| | - Sherry L Grace
- School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada
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Compare A, Grossi E, Bigi R, Proietti R, Shonin E, Orrego PS, Poole L. Stress-induced cardiomyopathy and psychological wellbeing 1 year after an acute event. J Clin Psychol Med Settings 2014; 21:81-91. [PMID: 24217954 DOI: 10.1007/s10880-013-9380-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Stress cardiomyopathy (SCM) typically presents similar symptoms to acute myocardial infarction (AMI). However, these symptoms differ when it comes to a transient and completely reversible myocardial dysfunction, which is frequently precipitated by acute stressful events, occurring in the absence of plaque rupture and coronary thrombosis. The purpose of this study was to investigate health-related quality of life (HRQL) and emotional burden subsequent to cardiac events in SCM patients. Thirty-seven SCM patients were compared with 37 matched AMI patients. All selected patients were assessed for HRQL and psychological distress at baseline and 1-year after the acute event. After controlling for covariates, scores on the Psychological General Well Being Index indicated that depressed mood had increased in both groups, but the increase for SCM patients was greater than for AMI patients. The AMI group displayed greater decreases than the SCM in physical quality of life and in total cardiac-related health quality of life. The percentage of patients with psychological distress increased significantly more in the SCM group than in the AMI group, and it made no difference whether the triggering event was emotional or physical. Our results suggest that, despite the more favorable medical prognosis of SCM patients, their cardiac condition being transient and resolving completely in few weeks, the psychological impact associated with their condition is more negative 1 year later than in the case of AMI patients whose medical prognosis is less favorable, and this difference is independent of type of trigger event.
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Affiliation(s)
- Angelo Compare
- University of Bergamo, Piazzale S. Agostino 2, 24129, Bergamo, Italy,
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Colella TJF, Gravely S, Marzolini S, Grace SL, Francis JA, Oh P, Scott LB. Sex bias in referral of women to outpatient cardiac rehabilitation? A meta-analysis. Eur J Prev Cardiol 2014; 22:423-41. [DOI: 10.1177/2047487314520783] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | | | | | | | | | - Paul Oh
- University of Toronto, Toronto, Canada
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