Socioeconomic Status, Secondary Prevention Activities and Recurrence After a Myocardial Infarction

NCT04199663 | Completed

• 1 other identifier: 3
• Study Type: observational
• Target: 30,191
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a nationwide cohort study on real-world patients (n≈30,000) surviving a first myocardial infarction (MI) 2006-2013 and alive to attend a routine 1-year follow-up. Associations between Socioeconomic Status (SES) and secondary preventive actions (SPAs) throughout the first year is studied and assessed as possible mechanisms underlying the increased risk of a first recurrent hard cardiocvascular (CV) outcome, recurrent atherosclerotic cardiovascular disease (rASCVD), in patients with low Socioeconomic Status during long-term follow-up (2006-2018).

Conditions

Socioeconomic Status; Secondary Prevention; Myocardial Infarction; Cardiovascular Disease; Stroke

Outcome Measures

Primary Outcomes (1)

• first recurrent atherosclerotic cardiovascular disease event (rASCVD)

  composite outcome including non-fatal MI (I210-I214, I219, I220, I221, I228 or I229) or coronary heart disease death (CHD) (I210-I214, I219, I220, I221, I228, I229, I461 or I469) or fatal or non-fatal ischemic stroke (I630-I635, I638 or I639) according to the International Classification of Diseases 10th edition (ICD-10)

  from date of 1-year visit post-MI (baseline) until date of outcome, censoring or study end (2018)

Other Outcomes (22)

• Goal: physical training program

  at 1-year revisit

• Goal: LDL-C goal

  at 1-year revisit

• Goal: Blood pressure goal

  at 1-year revisit

Study Arms (1)

categories of Socioeconomic Status (SES)

by proxy gender- and calendar year-specific quintiles of disposable income per household consumption unit. In logistic regression models of associations with secondary prevention activities and established treatment goals: highest vs. lowest income quintile. In multivariable Cox regression analyses with stepwise built models: quintiles of disposable income and models including covariates level of education and marital status.

Eligibility Criteria

• Age: 18 Years - 76 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

large nation-wide population of consecutive patients with assumed stable coronary heart disease after a myocardial infarction (first manifestation of atherosclerotic cardiovascular disease) in a tax-funded health care system.

You may qualify if:

• Swedish resident
• Alive and registered in The Swedish Websystem for Enhancement and Development of Evidence based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)'s secondary prevention subregistry between 1 January 2006 and 31 December 2013 at the 1-year-revisit

You may not qualify if:

• Age \>76 years at baseline
• Missing data for disposable household income
• History of MI, stroke, coronary artery bypass graft (CABG), or percutaneous coronary intervention (PCI) prior to the index MI
• Not present in initial care registry (RiksHIA)
• Date of index MI before 2004 or missing
• revisit outside 13±2 month window post-MI

Sponsors & Collaborators

• Karolinska Institutet: lead

MeSH Terms

Conditions

Myocardial Infarction; Cardiovascular Diseases; Stroke

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Per O Svensson, MD PhD

  Department of Clinical Science and Education, Söderjukhuset

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 88 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor

Study Record Dates

• First Submitted: December 12, 2019
• First Posted: December 16, 2019
• Study Start: January 1, 2006
• Primary Completion: December 31, 2018
• Last Updated: February 20, 2020

Record last verified: 2020-02