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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. | LitMetric

AI Article Synopsis

  • - The Managed Care in Acute Myocardial Infarction (MC-AMI) program in Poland aims to improve long-term outcomes for patients after a heart attack through comprehensive post-discharge care, including rehabilitation and follow-up.
  • - A study comparing 3,551 participants of MC-AMI to a control group found that MC-AMI participation was associated with a 38% reduction in all-cause mortality within one year, even after adjusting for various health factors.
  • - Key components of MC-AMI, particularly cardiac rehabilitation and consistent outpatient care, significantly contributed to this mortality reduction, highlighting the program's effectiveness in enhancing patient outcomes post-AMI.

Article Abstract

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, < 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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600386PMC
http://dx.doi.org/10.3390/jcm9103178DOI Listing

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