Managed Care after Acute Myocardial Infarction (MC-AMI) – a Poland’s nationwide program of comprehensive post-MI care - improves prognosis in 12-month follow-up. Preliminary experience from a single high-volume center

Wita, Krystian; Wilkosz, Katarzyna; Wita, Marcin; Kułach, Andrzej; Wybraniec, Maciej T.; Polak, Mateusz; Matla, Monika; Maciejewski, Łukasz; Fluder, Joanna; Kalańska-Łukasik, Barbara; Skowerski, Tomasz; Gomułka, Szymon; Turski, Maciej; Szydło, Krzysztof

doi:10.1016/j.ijcard.2019.06.040

Cited by 20 publications

(24 citation statements)

References 28 publications

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“…The challenge is that, despite growing evidence from meta-analyses, systematic reviews, and multicenter studies showing that CR improves the prognosis for IHD patients in terms of reduced hospital re-admissions, recurrent events, and mortality [2,20,21,22], there is still a low acceptance of CR overall in Poland. Our results confirm that there is a huge gap in referrals and enrollments between hospital discharge and participation in CR.…”

Section: Discussionmentioning

confidence: 99%

Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: A multicenter cross-sectional study

Sinnadurai¹,

Sowa²,

Jankowski³

et al. 2021

Polish Archives of Internal Medicine

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited, distributed under the same license, and used for noncommercial purposes only.

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Section: Discussionmentioning

confidence: 99%

Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: A multicenter cross-sectional study

Sinnadurai¹,

Sowa²,

Jankowski³

et al. 2021

Polish Archives of Internal Medicine

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“…However, many patients included in our study had MI before 2017 or were treated in centers not participating in the KOS -Zawał program and therefore the effects of the initiative might not be present in these cases. 27 According to the guidelines, all patients with a history of acute coronary syndrome or invasive treatment should take part in a rehabilitation or secondary prevention program. 8 We noted that not attending cardiac rehabilitation was negatively correlated with the level of risk factor control.…”

Section: What's New?mentioning

confidence: 99%

Knowledge and prevalence of risk factors for coronary artery disease in patients after the first and repeated percutaneous coronary intervention

Wójcicki¹,

Krycińska²,

Tokarek

et al. 2020

Kardiol Pol

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BACKGROUND Percutaneous coronary intervention (PCI) is an effective method for the treatment of coronary artery disease (CAD) that allows for a short hospital stay and fast recovery. It has been shown that PCI is a predictor of nonattendance at cardiac rehabilitation and correlates with poor adherence to lifestyle changes. AIMS The study was conducted to evaluate the influence of education offered during PCI -related hospitalization on knowledge, awareness, and prevalence of self -reported risk factors for CAD. METHODS We collected data using a self -designed 56-item questionnaire. Questions assessed the knowledge of CAD risk factors and the level of their control. The maximal knowledge score was 31 points and the maximal control score, 15 points. RESULTS The study group consisted of 200 consecutive patients undergoing PCI. Patients with a history of PCI performed at least 8 weeks prior to their current hospitalization were included in the prior -PCI group (64%), whereas the pre -PCI group comprised patients with no history of revascularization (36%). The median (interquartile range [IQR]) knowledge score was 19 (12.5-23) points in the pre -PCI and 21 (12.5-24) points in the prior -PCI group (P = 0.35). The median (IQR) risk control score was 5 (4.5-7) points in the pre -PCI and 6 (4-8) points in the prior -PCI group (P = 0.4). There was no correlation between the level of knowledge and the actual prevalence of CAD risk factors. We found that 50% of the prior -PCI patients did not attend any rehabilitation, which correlated with poor control of CAD risk factors (P = 0.001). CONCLUSIONS Currently used models of postprocedural education do not have an adequate effect on patient knowledge and do not bring recommended lifestyle changes.

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“…The program includes interventional treatment in AMI, staged complex revascularization, cardiac rehabilitation, scheduled follow-up visits, and prevention of SCD in eligible subjects [ 11 ]. As it has been proved in a single center analysis, MC-AMI is related to a 45% reduction of major adverse cardiovascular events (MACE) as soon as in 3-months [ 12 ] and 50% reduction of major adverse cardiovascular and cerebrovascular events (MACCE) in 12-month follow-up [ 13 ]. So far, there were no population or multicenter analyses of the effect of MC-AMI on mortality or even composite cardiovascular endpoints.…”

Section: Introductionmentioning

confidence: 99%

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

Wita

Kułach

Sikora

et al. 2020

JCM

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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.

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Managed Care after Acute Myocardial Infarction (MC-AMI) – a Poland’s nationwide program of comprehensive post-MI care - improves prognosis in 12-month follow-up. Preliminary experience from a single high-volume center

Cited by 20 publications

References 28 publications

Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: A multicenter cross-sectional study

Effects of cardiac rehabilitation on risk factor management and quality of life in patients with ischemic heart disease: A multicenter cross-sectional study

Knowledge and prevalence of risk factors for coronary artery disease in patients after the first and repeated percutaneous coronary intervention

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

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