Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population
Abstract Background The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients’ needs to be identified. The main objective of this study is to estimate the association between potentially preventable fa...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-020-01368-6 |
| _version_ | 1818969463243931648 |
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| author | E. Sverre K. Peersen H. Weedon-Fekjær J. Perk E. Gjertsen E. Husebye L. Gullestad T. Dammen J. E. Otterstad J. Munkhaugen |
| author_facet | E. Sverre K. Peersen H. Weedon-Fekjær J. Perk E. Gjertsen E. Husebye L. Gullestad T. Dammen J. E. Otterstad J. Munkhaugen |
| author_sort | E. Sverre |
| collection | DOAJ |
| description | Abstract Background The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients’ needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice. Methods This prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2–36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event. Results During a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes. Conclusions Coronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations. Trial registration Registered at ClinicalTrials.gov: NCT02309255 . Registered at December 5th, 2014, registered retrospectively. |
| first_indexed | 2024-12-20T14:20:59Z |
| format | Article |
| id | doaj.art-252e822f71fa451f9998363a4437df0f |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-20T14:20:59Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-252e822f71fa451f9998363a4437df0f2022-12-21T19:37:56ZengBMCBMC Cardiovascular Disorders1471-22612020-02-012011910.1186/s12872-020-01368-6Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary populationE. Sverre0K. Peersen1H. Weedon-Fekjær2J. Perk3E. Gjertsen4E. Husebye5L. Gullestad6T. Dammen7J. E. Otterstad8J. Munkhaugen9Department of Medicine, Drammen HospitalDepartment of Medicine, Vestfold HospitalOslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University HospitalDepartment of Cardiology, Public Health Department Linnaeus UniversityDepartment of Medicine, Drammen HospitalDepartment of Medicine, Drammen HospitalDepartment of Cardiology, Oslo University Hospital Rikshospitalet, Faculty of Medicine, University of OsloDepartment of Behavioural Sciences in Medicine and Faculty of Medicine, University of OsloDepartment of Medicine, Vestfold HospitalDepartment of Medicine, Drammen HospitalAbstract Background The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients’ needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice. Methods This prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2–36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event. Results During a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes. Conclusions Coronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations. Trial registration Registered at ClinicalTrials.gov: NCT02309255 . Registered at December 5th, 2014, registered retrospectively.https://doi.org/10.1186/s12872-020-01368-6Coronary heart diseaseSecondary preventionRisk factorsPsychosocial factorsPrognosisRecurrent cardiovascular events |
| spellingShingle | E. Sverre K. Peersen H. Weedon-Fekjær J. Perk E. Gjertsen E. Husebye L. Gullestad T. Dammen J. E. Otterstad J. Munkhaugen Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population BMC Cardiovascular Disorders Coronary heart disease Secondary prevention Risk factors Psychosocial factors Prognosis Recurrent cardiovascular events |
| title | Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| title_full | Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| title_fullStr | Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| title_full_unstemmed | Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| title_short | Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| title_sort | preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population |
| topic | Coronary heart disease Secondary prevention Risk factors Psychosocial factors Prognosis Recurrent cardiovascular events |
| url | https://doi.org/10.1186/s12872-020-01368-6 |
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