Attending Heart School and long-term outcome after myocardial infarction: A decennial SWEDEHEART registry study

Author:

Wallert John12,Olsson Erik MG1,Pingel Ronnie3,Norlund Fredrika1,Leosdottir Margret45,Burell Gunilla6,Held Claes78

Affiliation:

1. Department of Women’s and Children’s Health, Uppsala University, Sweden

2. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden

3. Department of Statistics, Uppsala University, Sweden

4. Department of Cardiology, Skåne University Hospital, Sweden

5. Department of Clinical Sciences Malmö, Lund University, Sweden

6. Department of Public Health and Caring Sciences, Uppsala University, Sweden

7. Department of Medical Sciences, Uppsala University Hospital, Sweden

8. Uppsala Clinical Research Center, Sweden

Abstract

Background The Heart School is a standard component of cardiac rehabilitation after myocardial infarction in Sweden. The group-based educational intervention aims to improve modifiable risks, in turn reducing subsequent morbidity and mortality. However, an evaluation with respect to mortality is lacking. Aims Using linked population registries, we estimated the association of attending Heart School with both all-cause and cardiovascular mortality, two and five years after admission for first-time myocardial infarction. Methods Patients with first-time myocardial infarction (<75 years) were identified as consecutively registered in the nationwide heart registry, SWEDEHEART (2006–2015), with >99% complete follow-up in the Causes of Death registry for outcome events. Of 192,059 myocardial infarction admissions, 47,907 unique patients with first-time myocardial infarction surviving to the first cardiac rehabilitation visit constituted the study population. The exposure was attending Heart School at the first cardiac rehabilitation visit 6–10 weeks post-myocardial infarction. Data on socioeconomic status was acquired from Statistics Sweden. After multiple imputation, propensity score matching was performed. The association of exposure with mortality was estimated with Cox regression and survival curves. Results After matching, attending Heart School was associated (hazard ratio (95% confidence interval)) with a markedly lower risk of both all-cause (two-year hazard ratio = 0.53 (0.44–0.64); five-year hazard ratio = 0.62 (0.55–0.69)) and cardiovascular (0.50 (0.38–0.65); 0.57 (0.47–0.69)) mortality. The results were robust in several sensitivity analyses. Conclusions Attending Heart School during cardiac rehabilitation is associated with almost halved all-cause and cardiovascular mortality after first-time myocardial infarction. The result warrants further investigation through adequately powered randomised trials.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3