Mobile App And Digital System For Patients After Myocardial Infarction (AfterAMI); Study Protocol For A Randomized Controlled Trial

Abstract Background: Treatment of acute myocardial infarction has been studied and improved over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient's prognosis. It is extremely important to take care of all cardiovascular risk factors.Mobile application ‘afterAMI’ supported by a web system is a novel telemedical tool developed to support patients and physicians during cardiac rehabilitation. The application has an educational model with a focus on cardiovascular risk factors and lifestyle after myocardial infarction. Moreover, it offers a module that controls vital signs like blood pressure, heart rate, weight, and many others. Additionally, the application will send reminders for better drug adherence.Methods: A group of 100 patients with myocardial infarction on admission at the 1st Chair and Department and of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analysed, along with issues like rehospitalizations, patients' knowledge of risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1- and 6-months after inclusion into the study.Discussion: This project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registration: ClinicalTrials.gov, NCT04793425, registered 11 March 2022.

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Mobile App and Digital System for Patients After Myocardial Infarction (AfterAMI); Study Protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-517597/v2 ◽

2021 ◽

Author(s):

Bartosz Krzowski ◽

Michał Peller ◽

Maria Boszko ◽

Paulina Hoffman ◽

Natalia Żurawska ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiac Rehabilitation ◽

Cardiovascular Risk Factors ◽

Controlled Trial ◽

Mobile App ◽

Clinical Practices ◽

Open Label ◽

The Impact

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Factor XIII Val34Leu polymorphism and the risk of myocardial infarction under the age of 36 years

Thrombosis and Haemostasis ◽

10.1160/th07-12-0755 ◽

2008 ◽

Vol 99 (06) ◽

pp. 1085-1089 ◽

Cited By ~ 15

Author(s):

Marianna Politou ◽

Christoforos Komporozos ◽

Demosthenes Panagiotakos ◽

Chrisoula Belessi ◽

Anthi Travlou ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Factor Xiii ◽

Control Group ◽

Lower Prevalence ◽

Premature Coronary Heart Disease ◽

Acute Mi ◽

The Impact

SummaryThere are limited and controversial data regarding the impact of factor XIII (FXIII) Val34Leu polymorphism in the pathogenesis of premature myocardial infarction (MI). We examined whether FXIII Val34Leu polymorphism is associated with the development of early MI.We recruited 159 consecutive patients who had survived their first acute MI under the age of 36 years (mean age=32.1 ± 3.6 years, 138 were men). The control group consisted of 121 healthy individuals matched with cases for age and sex, without a family history of premature coronary heart disease (CHD). FXIII Val34Leu polymorphism was tested with polymerase chain reaction and reverse hybridization. There was a lower prevalence of carriers of the Leu34 allele in patients than in controls (30.2 vs. 47.1%, p=0.006). FXIII Val34Leu polymorphism was associated with lower risk for acute MI after adjusting for major cardiovascular risk factors (odds ratio [OR] = 0.51, 95% confidence interval [CI] 0.27–0.95, p=0.03). Subgroup analysis according to angiographic findings (“normal” coronary arteries [n=29] or significant CHD [n=130]) showed that only patients with MI and significant CHD had lower prevalence of carriers of the Leu34 allele compared to controls after adjusting for major cardiovascular risk factors (OR = 0.42, 95% CI 0.22–0.83, p=0.01). Our data indicate that FXIII Val34Leu polymorphism has a protective effect against the development of MI under the age of 36 years, particularly in the setting of significant CHD.

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Abstract P347: The Impact of the Length of the Follow-up on the the Strengths of the Associations Between Cardiovascular Risk Factors and Future Myocardial Infarction, Stroke and Heart Failure

Circulation ◽

10.1161/circ.125.suppl_10.ap347 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Lars Lind ◽

Erik Ingelsson ◽

Johan Sundström ◽

Johan ärnlöv

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Heart Failure ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cardiovascular Outcomes ◽

Rapid Decline ◽

The Impact ◽

Over Time

Objective: The aim of this study was to investigate how the length of the follow-up period influences the strength of the associations between major cardiovascular risk factors and different cardiovascular outcomes (myocardial infarction [MI], stroke and heart failure). Methods: We examined 1826 men aged 50 regarding cardiovascular risk factors in 1970-74. The follow-up time was 33 years. The hazard ratio (HR) was calculated yearly for each risk factor and outcome. During follow-up, 571 cases of MI, 381 cases of stroke and 384 cases of heart failure occurred. Results: Two major patterns were found regarding influence of the follow-up time on the associations between risk factors and the different cardiovascular outcomes. First, a gradual decline in the HR over time was seen for blood pressure in relation to all three outcomes, with the most rapid decline for heart failure and stroke. This pattern was also seen for BMI in relation to MI and heart failure, and for smoking regarding MI and stroke. Second, we observed a gradual increase in HRs to a maximum at 20-25 years, and thereafter a slight decline. This pattern was seen for the apoB/A1 ratio, HDL, and triglycerides, mainly in relation to MI and heart failure. Conclusion: The length of follow-up influenced the associations between traditional risk factors and cardiovascular outcomes in different ways. The collective influence of the risk factors did however show a substantial decline in discrimination over time for the outcomes stroke and heart failure, but not regarding myocardial infarction.

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Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

European Heart Journal ◽

10.1093/eurheartj/ehab724.0247 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

I Lechner ◽

M Reindl ◽

C Tiller ◽

M Holzknecht ◽

A Mayr ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Aortic Stiffness ◽

Prognostic Significance ◽

St Elevation Myocardial Infarction ◽

Adjusted Analysis ◽

St Elevation ◽

The Impact

Abstract Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regressionand logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p<0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p<0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p>0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p=0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Austrian Science Fund (FWF)Austrian Society of Cardiology Figure 1. Biorender.com

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Association between attending exercise-based cardiac rehabilitation and cardiovascular risk factors at one-year post myocardial infarction

PLoS ONE ◽

10.1371/journal.pone.0232772 ◽

2020 ◽

Vol 15 (5) ◽

pp. e0232772

Author(s):

Ingela Sjölin ◽

Maria Bäck ◽

Lennart Nilsson ◽

Alexandru Schiopu ◽

Margret Leosdottir

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiac Rehabilitation ◽

Cardiovascular Risk Factors ◽

Post Myocardial Infarction ◽

One Year

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The impact of social status inconsistency on cardiovascular risk factors, myocardial infarction and stroke in the EPIC-Heidelberg cohort

BMC Public Health ◽

10.1186/1471-2458-11-104 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 14

Author(s):

Stefanie Braig ◽

Richard Peter ◽

Gabriele Nagel ◽

Silke Hermann ◽

Sabine Rohrmann ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Social Status ◽

Cardiovascular Risk Factors ◽

Status Inconsistency ◽

The Impact

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Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.281 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

I Lechner ◽

M Reindl ◽

C Tiller ◽

M Holzknecht ◽

A Mayr ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Aortic Stiffness ◽

Prognostic Significance ◽

St Elevation Myocardial Infarction ◽

Adjusted Analysis ◽

St Elevation ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. Purpose We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. Methods We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (pPCI). Aortic pulse wave velocity (PWV), a direct measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 (interquartile range [IQR] 12–31) months. Cox regression- and logistic regression analysis were performed to explore predictors of PWV and MACCE. Results Median aortic PWV was 6.6 m/s (IQR 5.6–8.3m/s). In multivariable analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI], 1.08–1.14, p < 0.001) and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with higher PWV. Gender, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis (hazard ratio [HR] 2.45, 95% CI 1.19–5.04, p = 0.014). Conclusion In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome, suggesting it as a relevant therapeutic target in this population.

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Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02383-0 ◽

2021 ◽

Author(s):

Ivan Lechner ◽

Martin Reindl ◽

Christina Tiller ◽

Magdalena Holzknecht ◽

Sarah Niederreiter ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Aortic Stiffness ◽

Prognostic Significance ◽

St Elevation Myocardial Infarction ◽

Adjusted Analysis ◽

St Elevation ◽

The Impact

AbstractThe association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), the most widely used measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 [interquartile range (IQR) 12–31] months. Cox regression- and logistic regression analysis were performed to explore predictors of aortic stiffness and MACCE. Median aortic PWV was 6.6 m/s (IQR 5.6–8.3 m/s). In multivariable analysis, age [odds ratio (OR) 1.10, 95% confidence interval (CI), 1.08–1.14, p < 0.001] and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis [hazard ratio (HR) 2.45, 95% CI 1.19–5.04, p = 0.014]. In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. Trial (NCT04113356).

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