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- Title
Long-term outcomes of the Coordinated Care Program in Patients after Myocardial Infarction (KOS-MI).
- Authors
Kolarczyk-Haczyk, Aleksandra; Konopko, Marta; Mazur, Marta; Żurakowski, Aleksander; Gąsior, Mariusz; Rogala, Maciej; Jankowski, Piotr; Kaźmierczak, Paweł; Milewski, Krzysztof P.; Buszman, Paweł E.; Buszman, Piotr P.
- Abstract
Background: The Coordinated Care in Myocardial Infarction Program (KOS-MI) was introduced to improve prognosis for patients after myocardial infarction (MI). The program includes complete revascularization followed by unrestricted access to rehabilitation, electrotherapy, and cardiac care. Aim: This study aimed to assess major adverse cardiac and cerebrovascular events (MACCE) of patients enrolled in the KOS-MI at 3-year follow-up. Methods: This is a retrospective, multicenter registry of patients treated for MI. The study group (KOS-MI) of 963 patients was compared to the control group (standard care) of 1009 patients. At 3-year follow-up, MACCE including death, MI, stroke, and repeated revascularization were reported. Additionally, hospitalization for heart failure (HF) was analyzed. Propensity score matching (PSM) was utilized for group baseline characteristic adjustment. Results: Patients in the KOS-MI group were younger (65 vs. 68 years; P <0.001), mostly men (70% vs. 62.9%; P <0.001), admitted with ST-segment elevation myocardial infarction (STEMI) (44.6% vs. 36.2%; P <0.001). Patients in the control group had more comorbidities and were admitted more often with non-ST-segment elevation myocardial infarction (63.8% vs. 55.4%; P <0.001) and acute HF (5.1% vs. 2.7%; P = 0.007). Following PSM, 530 well matched pairs were selected. At three years (92.3% follow-up completeness), the relative risk reduction was: 25% in MACCE (P = 0.008), 38% in mortality (P = 0.008), 29% in repeated revascularization (P = 0.04), and 28% (P = 0.0496) in hospitalization for HF in the KOS-MI group. Conclusions: The combination of contemporary invasive techniques, complete revascularization, cardiac rehabilitation, and ambulatory care included in the KOS-MI Program improves long-term prognosis of patients after MI in 3-year follow-up.
- Subjects
EVALUATION of medical care; RESEARCH; OUTPATIENT medical care; OPERATIVE surgery; MAJOR adverse cardiovascular events; MYOCARDIAL infarction; RETROSPECTIVE studies; COMPARATIVE studies; ST elevation myocardial infarction; PREVENTIVE health services; MYOCARDIAL revascularization; CARDIAC rehabilitation; DESCRIPTIVE statistics; NON-ST elevated myocardial infarction; COMORBIDITY; HEART failure; EVALUATION
- Publication
Polish Heart Journal / Kardiologia Polska, 2023, Vol 81, Issue 6, p587
- ISSN
0022-9032
- Publication type
Article
- DOI
10.33963/KP.a2023.0091