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Article: Clinical predictors of morbidity and mortality in patients with myocardial infarction or revascularization who underwent cardiac rehabilitation, and importance of diabetes mellitus and exercise capacity

TitleClinical predictors of morbidity and mortality in patients with myocardial infarction or revascularization who underwent cardiac rehabilitation, and importance of diabetes mellitus and exercise capacity
Authors
KeywordsReferences (30) View In Table Layout
Issue Date2000
PublisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2000, v. 85 n. 3, p. 344-349 How to Cite?
AbstractThis investigation was a prospective, follow-up study to assess whether baseline clinical and investigational parameters were predictors of cardiovascular morbidity and mortality in patients enrolled into the cardiac rehabilitation program. A cohort of 418 patients (70% were men) with coronary heart disease was followed up 3.2 ± 1.1 years. Two hundred twenty-seven of them (54%) had a recent myocardial infarction (MI), with a thrombolytic rate of 54%. Percutaneous transluminal coronary angioplasty (PTCA) was performed in 45% of patients. The covariates assessed include age, gender, smoking habit, body mass index, the presence of hypertension or diabetes mellitus, exercise habit, site and severity of MI, status of thrombolytic therapy, peak creatine phosphokinase, plasma lipid profiles, ejection fraction, PTCA performed, number of diseased coronary arteries, and exercise capacity. Low-density lipoprotein cholesterol decreased significantly (3.2 ± 1.0 vs 2.7 ± 0.7 mmol/L, p <0.001). The cumulative mortality was 13%. In a univariate model, the parameters that significantly predict mortality included older age, diabetes, low exercise capacity (≤4 metabolic equivalents) 3-vessel disease, those without PTCA performed, and a low ejection fraction. In the Cox proportional-hazards model analysis, the independent factors were coexisting diabetes (chi-square 6.1, p = 0.01) and a low metabolic equivalent (chi-square 6.5, p = 0.01). One hundred six patients were rehospitalized for nonfatal cardiovascular events that included unstable angina (48%), heart failure (21%), acute MI (6%), symptomatic arrhythmia (6%), and severe hypertension (1%). Factors that independently predicted rehospitalization were low exercise capacity (p = 0.02) and the presence of diabetes (chi-square 4.8, p = 0.03). Diabetes was also associated with more episodes of hospital admission (2.3 ± 2.1 vs 1.6 ± 1.4, p = 0.04) and a longer cumulative hospital stay (25.5 ± 34.6 vs 11.4 ± 19.6 days, p = 0.02). Thus, in patients with MI or after PTCA receiving conventional medical therapy, the cardiac rehabilitation program should focus on aggressive diabetic control and enhancement of exercise capacity. Copyright (C) 2000 Excerpta Medica Inc.
Persistent Identifierhttp://hdl.handle.net/10722/91546
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYu, CMen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorCheung, BMYen_HK
dc.contributor.authorFong, YMen_HK
dc.contributor.authorHo, YYen_HK
dc.contributor.authorLam, KBen_HK
dc.contributor.authorLi, LSWen_HK
dc.date.accessioned2010-09-17T10:21:08Z-
dc.date.available2010-09-17T10:21:08Z-
dc.date.issued2000en_HK
dc.identifier.citationAmerican Journal Of Cardiology, 2000, v. 85 n. 3, p. 344-349en_HK
dc.identifier.issn0002-9149en_HK
dc.identifier.urihttp://hdl.handle.net/10722/91546-
dc.description.abstractThis investigation was a prospective, follow-up study to assess whether baseline clinical and investigational parameters were predictors of cardiovascular morbidity and mortality in patients enrolled into the cardiac rehabilitation program. A cohort of 418 patients (70% were men) with coronary heart disease was followed up 3.2 ± 1.1 years. Two hundred twenty-seven of them (54%) had a recent myocardial infarction (MI), with a thrombolytic rate of 54%. Percutaneous transluminal coronary angioplasty (PTCA) was performed in 45% of patients. The covariates assessed include age, gender, smoking habit, body mass index, the presence of hypertension or diabetes mellitus, exercise habit, site and severity of MI, status of thrombolytic therapy, peak creatine phosphokinase, plasma lipid profiles, ejection fraction, PTCA performed, number of diseased coronary arteries, and exercise capacity. Low-density lipoprotein cholesterol decreased significantly (3.2 ± 1.0 vs 2.7 ± 0.7 mmol/L, p <0.001). The cumulative mortality was 13%. In a univariate model, the parameters that significantly predict mortality included older age, diabetes, low exercise capacity (≤4 metabolic equivalents) 3-vessel disease, those without PTCA performed, and a low ejection fraction. In the Cox proportional-hazards model analysis, the independent factors were coexisting diabetes (chi-square 6.1, p = 0.01) and a low metabolic equivalent (chi-square 6.5, p = 0.01). One hundred six patients were rehospitalized for nonfatal cardiovascular events that included unstable angina (48%), heart failure (21%), acute MI (6%), symptomatic arrhythmia (6%), and severe hypertension (1%). Factors that independently predicted rehospitalization were low exercise capacity (p = 0.02) and the presence of diabetes (chi-square 4.8, p = 0.03). Diabetes was also associated with more episodes of hospital admission (2.3 ± 2.1 vs 1.6 ± 1.4, p = 0.04) and a longer cumulative hospital stay (25.5 ± 34.6 vs 11.4 ± 19.6 days, p = 0.02). Thus, in patients with MI or after PTCA receiving conventional medical therapy, the cardiac rehabilitation program should focus on aggressive diabetic control and enhancement of exercise capacity. Copyright (C) 2000 Excerpta Medica Inc.en_HK
dc.languageengen_HK
dc.publisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/en_HK
dc.relation.ispartofAmerican Journal of Cardiologyen_HK
dc.subjectReferences (30) View In Table Layouten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAngioplasty, Balloon, Coronary - mortality - rehabilitationen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshDiabetes Complicationsen_HK
dc.subject.meshDisease-Free Survivalen_HK
dc.subject.meshExerciseen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHospitalization - statistics & numerical dataen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMorbidityen_HK
dc.subject.meshMyocardial Infarction - complications - mortality - rehabilitationen_HK
dc.subject.meshProportional Hazards Modelsen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRisk Factorsen_HK
dc.titleClinical predictors of morbidity and mortality in patients with myocardial infarction or revascularization who underwent cardiac rehabilitation, and importance of diabetes mellitus and exercise capacityen_HK
dc.typeArticleen_HK
dc.identifier.emailCheung, BMY:mycheung@hku.hken_HK
dc.identifier.authorityCheung, BMY=rp01321en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0002-9149(99)00744-4en_HK
dc.identifier.pmid11078304-
dc.identifier.scopuseid_2-s2.0-0033984128en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033984128&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume85en_HK
dc.identifier.issue3en_HK
dc.identifier.spage344en_HK
dc.identifier.epage349en_HK
dc.identifier.isiWOS:000084989800012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYu, CM=7404976646en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridCheung, BMY=7103294806en_HK
dc.identifier.scopusauthoridFong, YM=35895135000en_HK
dc.identifier.scopusauthoridHo, YY=7402554967en_HK
dc.identifier.scopusauthoridLam, KB=7403656842en_HK
dc.identifier.scopusauthoridLi, LSW=7501450364en_HK

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