Community-Based Lifestyle Intervention in Patients With Coronary Artery Disease

Minneboo, Madelon; Lachman, Sangeeta; Snaterse, Marjolein; Jørstad, Harald T; Riet, Gerben ter; Boekholdt, S. Matthijs; Reimer, Wilma J.M. Scholte op; Peters, Ron J.G.

doi:10.1016/j.jacc.2017.05.041

Cited by 78 publications

(89 citation statements)

References 28 publications

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“…Another interesting finding came from the RESPONSE‐2 (Randomised Evaluation of Secondary Prevention by Outpatient Nurse Specialists 2) study, which studied the impact of a nurse‐coordinated referral to community‐based lifestyle programs to control smoking, overweight, and physical inactivity. Participation of patient's partners was associated with a significantly greater success rate 133. Thus, regular face‐to‐face contacts with specialized nurses and physicians in combination with telemonitoring systems and the inclusion of partners might help translate the proven health benefits of rehabilitation programs into long‐standing lifestyle changes and improved prognoses.…”

Section: Perspectivesmentioning

confidence: 99%

“…Participation of patient's partners was associated with a significantly greater success rate. 133 Thus, regular face-to-face contacts with specialized nurses and physicians in combination with telemonitoring systems and the inclusion of partners might help translate the proven health benefits of rehabilitation programs into long-standing lifestyle changes and improved prognoses.…”

Section: Perspectivesmentioning

confidence: 99%

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Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Winzer

Woitek

Linke

2018

JAHA

178

120

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Section: Perspectivesmentioning

confidence: 99%

Section: Perspectivesmentioning

confidence: 99%

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Winzer

Woitek

Linke

2018

JAHA

178

120

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“…Secondary prevention programs, with particular emphasis on intensive lifestyle modification including weight reduction and smoking cessation, have been proven to be beneficial among patients with coronary artery disease (CAD) . Although recent studies showed adequately treated lifestyle factors were associated with success rates of catheter ablation, significant gaps still exist in the understanding of the definition of treatment targets for the individual risk factors in patients with AF.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of modifiable risk factors and relation to stroke and death in patients with atrial fibrillation: A report from the China atrial fibrillation registry study

Jiang

Lan

et al. 2019

Cardiovasc electrophysiol

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Background Lifestyle and risk factor management may improve outcomes in patients with atrial fibrillation (AF). We aim to evaluate the prevalence of modifiable risk factors and how these factors impact clinical outcomes in patients with AF. Methods and Results Data on 17 898 AF cohort patients with AF enrolled between 2011 and 2016 was analyzed. A healthy lifestyle was defined as not smoking, not drinking, a healthy body mass index (BMI), untreated total cholesterol less than 200 mg/dL, untreated blood pressure (BP) less than 120/80 mm Hg, and untreated fasting plasma glucose (FPG) less than 100 mg/dL. The association between risk factors and risk of the composite endpoint of all‐cause mortality and nonfatal ischemic stroke were assessed using Cox proportional hazards regression model. Only 4.0% of patients achieved a healthy lifestyle. In multivariate analysis, current smoking, a low BMI, not well‐controlled FPG were independently and significantly associated with higher risk of all‐cause mortality and nonfatal ischemic stroke, with corresponding hazard ratio (HR) estimates 1.22 (95% confidence interval [CI], 1.00‐1.47), HR = 1.72 (95% CI, 1.34‐2.20), and HR = 1.25 (95% CI, 1.06‐1.46), respectively. High BP was also associated with higher risk with the outcomes (HR = 1.15, 95% CI, 1.00‐1.34). Compared with patients with no risk factor, those who failed to maintained or achieved optimal risk factor control had a progressively higher risk of death and nonfatal ischemic stroke (HR for 1 risk factor = 1.44; 95% CI, 1.07‐1.92; and more than 2 risk factors = 1.75; 95% CI, 0.99‐3.09). Conclusions Maintenance of well‐controlled risk factors may substantially lower the risk of death and ischemic stroke in patients with AF.

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“…Even in the COURAGE study, after 5 years, the proportion of patients who smoked was only reduced from 23% to 19%, the proportion of patients who engaged in physical activity increased from 58% to 66% and body mass index (BMI) increased from 28.8% to 29.3 kg/m 2. The best results were obtained in the recent RESPONSE‐2 study, in which intervention led to a significant improvement in lifestyles (37% in the case group vs 26% in control group), and in the Nurses' Health Study and Health Professionals Follow‐up Study, in which there was a total mortality reduction of 17% …”

Section: Discussionmentioning

confidence: 99%

“…30 Even in the COURAGE study, after 5 years, the proportion of patients who smoked was only reduced from 23% to 19%, the proportion of patients who engaged in physical activity increased from 58% to 66% and body mass index (BMI) increased from 28.8% to 29.3 kg/m 2. 31 The best results were obtained in the recent RESPONSE-2 study, in which intervention led to a significant improvement in lifestyles (37% in the case group vs 26% in control group), 32 34 However, it should be stressed that if risky lifestyle factors persist (especially cigarette smoking), the residual risk remains high despite treatment with statins. 35 Revascularization improves the quality of life by reducing symptoms in patients who have recurrent chest pain despite optimal medical therapy but does not reduce either the risk of heart attack or the risk of death.…”

Section: Methodsmentioning

confidence: 99%

Stable atypical chest pain with negative anatomical or functional diagnostic test: Diagnosis no matter what or prevention at any cost?

Cosmi¹,

Mariottoni

Cosmi

2019

Clinical Cardiology

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Background Approximately 1% to 2% of patients with stable atypical chest pain (SACP) experienced a major coronary event, even after a negative functional or anatomical test. Methods Over the past 15 years, 1706 patients with SACP evaluated in our clinics underwent functional stress testing or coronary computed tomographic angiography (CTA). In these patients, we also assessed the presence of three major modifiable lifestyle‐related risk factors (cigarette smoking, low intake of fruit and vegetables, and physical inactivity). Patients were stratified according to the presence of at least one risky lifestyle factor or no risky lifestyle factors. Functional or anatomical tests were positive in 170 patients (10%). We followed the remaining 1536 patients with negative tests for 1 year to evaluate the incidence of major coronary events. Results The percentage of patients reporting major coronary events was 1.2% in the group with risky lifestyles and 0.2% in the non‐risky lifestyle group (P < .01). Events were more common in smokers. Conclusions Patients with SACP, when functional or anatomical tests are negative, have a residual risk of fatal and non‐fatal cardiovascular events of 1% at 1 year of follow‐up. People with incorrect lifestyles, especially smokers, have a higher risk of events. We think that in this population, a more effective intervention on lifestyles could be the key to reduce major cardiovascular events.

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Community-Based Lifestyle Intervention in Patients With Coronary Artery Disease

Cited by 78 publications

References 28 publications

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Prevalence of modifiable risk factors and relation to stroke and death in patients with atrial fibrillation: A report from the China atrial fibrillation registry study

Stable atypical chest pain with negative anatomical or functional diagnostic test: Diagnosis no matter what or prevention at any cost?

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