scholarly journals Long-term effects of the Managed Care After Myocardial Infarction programme: an update on complete one-year follow-up

2020 ◽  
Author(s):  
Maciej T. Wybraniec ◽  
Katarzyna Mizia-Stec ◽  
Zbigniew Gąsior ◽  
Wojciech Wojakowski ◽  
Krzysztof S. Gołba ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Managed Care ◽  
Long Term Effects ◽  
One Year

Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Wienbergen ◽  
A Fach ◽  
S Meyer ◽  
J Schmucker ◽  
R Osteresch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Prevention Program ◽  
Study Endpoint ◽  
Funding Source ◽  
Risk Factor Control ◽  
One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after >24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p<0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p<0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p<0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after >24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

The long-term effects of homeopathic treatment of chronic headaches: one year follow-up and single case time series analysis

2001 ◽  
Vol 90 (02) ◽  
pp. 63-72 ◽  
Author(s):  
H Walach ◽  
T Lowes ◽  
D Mussbach ◽  
U Schamell ◽  
W Springer ◽  
...  
Keyword(s):  
Time Series ◽  
Single Case ◽  
Double Blind Study ◽  
Long Term Effects ◽  
Double Blind ◽  
Homeopathic Treatment ◽  
Chronic Headaches ◽  
One Year

AbstractLittle is known about long-term effects of homeopathic treatment. Following a double-blind, placebo controlled trial of classical homeopathy in chronic headaches, we conducted a 1-year observational study of 18 patients following the double-blind phase, and a complete follow-up study of all trial participants. Eighteen patients received free treatment for daily diary data (frequency, intensity, duration of headaches) over the course of 1 y. All patients enrolled in the double-blind study were sent a 6-week headache diary, a follow-up questionnaire, a personality inventory and a complaint list. Eighty-seven, of the original 98 patients enrolled returned questionnaires, 81 returned diaries. There was no additional change from the end of the trial to the one-year follow-up. The improvement seen at the end of the 12-week trial was stable after 1 y. No differential effects according to treatment after the trial could be seen. Patients with no treatment following the trial had the most improvement after 1 y. Five of 18 patients can be counted responders according to ARIMA analysis of single-case time-series. Patients with double diagnoses and longer treatment duration tended to have clearer improvements than the rest of the patients. Approximately 30% of patients in homeopathic treatment will benefit after 1 y of treatment. There is no indication of a specific, or of a delayed effect of homeopathy.

Long-term effects of empathy training in surgery residents: a one year follow-up study

2013 ◽  
Vol 1 (2) ◽  
pp. 326 ◽  
Author(s):  
Margot Phillips ◽  
Aine Lorie ◽  
John Kelley ◽  
Stacy Gray ◽  
Helen Riess
Keyword(s):  
Long Term Effects ◽  
Clinical Practices ◽  
Empathy Training ◽  
Self Reflection ◽  
Booster Sessions ◽  
Before And After ◽  
Quantitative Analyses ◽  
One Year

Objectives: This study is a 1-year follow-up investigation of the retention of the knowledge, attitudes and skills acquired after empathy training.Methods: Eight otolaryngology residents completed 5 assessment measures before and after empathy training and at 1-year. They attended a 90-minute focus group assessing clinical usefulness of the training, attitudes and factors that affect empathy.Results: Qualitative analysis revealed a positive response to the training and application of skills to clinical practices. Quantitative analyses suggest improvement in empathy after training was maintained at 1-year follow-up (p = 0.05). Knowledge of the neurobiology and physiology of empathy remained significantly greater than before the training (p = 0.007). Conclusions: Qualitative data indicate that the training program was well-received and helpful and follow-up focus groups provided physicians with opportunities for self-reflection and support from peers. Quantitative analysis demonstrated that improvement in self-reported empathy and objective knowledge of the neurobiology of emotions persist at 1-year follow-up. Accordingly, we recommend that empathy training and follow-up booster sessions become a standard component of residency training.

scholarly journals Long-term impact of chronic total occlusion recanalisation in patients with ST-elevation myocardial infarction

Heart ◽  
2018 ◽  
Vol 104 (17) ◽  
pp. 1432-1438 ◽  
Author(s):  
Joëlle Elias ◽  
Ivo M van Dongen ◽  
Truls Råmunddal ◽  
Peep Laanmets ◽  
Erlend Eriksen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Death ◽  
Chronic Total Occlusion ◽  
Randomised Trial ◽  
Left Ventricular ◽  
Total Occlusion ◽  
St Elevation ◽  
One Year

BackgroundDuring primary percutaneous coronary intervention (PCI), a concurrent chronic total occlusion (CTO) is found in 10% of patients with ST-elevation myocardial infarction (STEMI). Long-term benefits of CTO-PCI have been suggested; however, randomised data are lacking. Our aim was to determine mid-term and long-term clinical outcome of CTO-PCI versus CTO-No PCI in patients with STEMI with a concurrent CTO.MethodsThe Evaluating Xience and left ventricular function in PCI on occlusiOns afteR STEMI (EXPLORE) was a multicentre randomised trial that included 302 patients with STEMI after successful primary PCI with a concurrent CTO. Patients were randomised to either CTO-PCI or CTO-No PCI. The primary end point of the current study was occurrence of major adverse cardiac events (MACE): cardiac death, coronary artery bypass grafting and MI. Other end points were 1-year left ventricular function (LVF); LV-ejection fraction and LV end-diastolic volume and angina status.ResultsThe median long-term follow-up was 3.9 (2.1–5.0) years. MACE was not significantly different between both arms (13.5% vs 12.3%, HR 1.03, 95% CI 0.54 to 1.98; P=0.93). Cardiac death was more frequent in the CTO-PCI arm (6.0% vs 1.0%, P=0.02) with no difference in all-cause mortality (12.9% vs 6.2%, HR 2.07, 95% CI 0.84 to 5.14; P=0.11). One-year LVF did not differ between both arms. However, there were more patients with freedom of angina in the CTO-PCI arm at 1 year (94% vs 87%, P=0.03).ConclusionsIn this randomised trial involving patients with STEMI with a concurrent CTO, CTO-PCI was not associated with a reduction in long-term MACE compared to CTO-No PCI. One-year LVF was comparable between both treatment arms. The finding that there were more patients with freedom of angina after CTO-PCI at 1-year follow-up needs further investigation.Clinical trial registrationEXPLORE trial number NTR1108 www.trialregister.nl.

scholarly journals Managed Care after Acute Myocardial Infarction (MC-AMI) Reduces Total Mortality in 12-Month Follow-Up—Results from a Poland’s National Health Fund Program of Comprehensive Post-MI Care—A Population-Wide Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3178
Author(s):  
Krystian Wita ◽  
Andrzej Kułach ◽  
Jacek Sikora ◽  
Joanna Fluder ◽  
Ewa Nowalany-Kozielska ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Managed Care ◽  
Cardiac Rehabilitation ◽  
National Health ◽  
Cox Regression ◽  
Mortality Reduction ◽  
Health Fund ◽  
One Year

Introduction: Advances in the acute treatment of myocardial infarction (AMI) substantially reduced in-hospital mortality, but the post-discharge prognosis is still unacceptable. The Managed Care in Acute Myocardial Infarction (MC-AMI) is a program of Poland’s National Health Fund that aims at comprehensive post-AMI care to improve long-term prognosis. The aim of the study was to assess the effect of MC-AMI on all-cause mortality in one-year follow-up. Methods: MC-AMI includes acute MI treatment, complex revascularization, cardiac rehabilitation (CR), scheduled one-year outpatient follow-up, and prevention of sudden cardiac death. In this retrospective observational study performed in a province of Silesia, Poland, we analyzed 3893 MC-AMI participants, and compared them to 6946 patients in the control group. After propensity score matching, we compared two groups of 3551 subjects each. To assess the effect of MC-AMI and other variables on mortality, we preformed a Cox regression. Results: MC-AMI was related with mortality reduction by 38% in a 12-month observation period and the effect persisted even after. Multivariable Cox regression analysis revealed MC-AMI participation to be inversely associated with 1-year mortality (HR 0.52, 95%CI 0.42–0.65, p < 0.001). Besides that, older age (HR 1.47/10 y), ST-elevation AMI (HR 1.41), heart failure (HR 2.08), diabetes (HR 1.52), and dialysis (HR 2.38) were significantly associated with the primary endpoint. Among MC-AMI components, cardiac rehabilitation (HR 0.34) and strict outpatient care (HR 0.42) are the crucial factors affecting mortality reduction. Conclusions: Participation in MC-AMI reduced 1-year mortality by 38% and the effect persisted after the program had been completed.

Long-term effects of orthotic insoles in rheumatoid arthritis—A one-year year longitudinal follow-up

2006 ◽  
Vol 24 ◽  
pp. S178-S179
Author(s):  
Arne Nagel ◽  
Henrik Schmiegel Andreas Lars ◽  
Dieter Rosenbaum
Keyword(s):  
Rheumatoid Arthritis ◽  
Long Term Effects ◽  
One Year ◽  
Orthotic Insoles

scholarly journals IMPACT OF DIFFERENT ANGIOTENSIN-CONVERTING INHIBITORS ON OUTCOMES OF POST-MYOCARDIAL INFARCTION PATIENTS

2020 ◽  
Vol 73 (3) ◽  
pp. 555-560
Author(s):  
Marian V. Hrebenyk ◽  
Larysa Yu. Bidovanets
Keyword(s):  
Myocardial Infarction ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Left Ventricular ◽  
Post Myocardial Infarction ◽  
Long Term Effects ◽  
Converting Enzyme Inhibitors ◽  
Function Recovery

The aim: To compare the long-term effects of different angiotensin-converting enzyme inhibitors in post-myocardial infarction (MI) patients. Materials and methods: Of 445 consecutive patients with myocardial infarction, 76 (17%) patients had co-morbid conditions, as well as were found to be compliant with secondary prevention treatment and eligible for follow-up. These patients were assigned to ramipril, perindopril or zofenopril groups in complex management of post-MI period. Subsequently, the patients were followed-up prospectively for a period of up to 24 months. Results: Patients of zofenopril group performed better in terms of post-MI biventricular remodeling and left ventricular function recovery. Also, patients receiving zofenopril showed benefits in terms of short-term and long-term mortality as compared with patients of ramipril and perindopril groups. Conclusion: Zofenopril may have advantages over perindopril and ramipril in the complex management of post-MI patients in terms of prevention of negative myocardial remodeling, onset of congestive heart failure and major adverse events.

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