Name & Department: Department of Population Medicine and Lifestyle Disease Prevention
Public PhD Defence date: 28.11.2022
Doctoral Thesis title: Integrated approach to cardiovascular risk factor management in patients with chronic coronary syndromes
Supervisor/s: Prof. dr hab. Karol Adam Kaminski
Reviewers:
Professor dr hab. n. o zdr. Agnieszka Mlynarskiej
Professor dr hab. N. med. Agata Bieleckiej Dabrowy
Professor dr hab. N. med. Jacek Niedziela
Current affiliation: Medical Center of Postgraduate Education in Warsaw
Plans for the Future: To make further efforts to pursue the truth and contribute to the people’s health
Abstract (max 1000 characters with spaces):
Secondary prevention strategies rates remain poor in Europe as well in Poland. Cardiac rehabilitation (CR) improves survival outcomes in patients with ischemic heart disease (IHD), however the long term benefits of short-term programs are still discussed. We aimed to assess the impact of CR on risk factor management in a multicentre real-life registry of patients with chronic coronary syndrome. Of 1012 interviewed patients (28.6% women), 35.6% were referred for CR and 76.1% of them completed the program. We found those referred were younger (P <0.001), employed (P <0.001), have presented with ST-segment elevation myocardial infarction (P <0.001), had hypertension (P <0.001), and were current smokers (P <0.001). Logistic regression revealed that patients who participated in CR were more likely to stop smoking (odds ratio [OR], 2.42; 95% CI, 1.33-4.14), achieve acceptable glucose control (OR, 1.70; 95% CI, 1.02-2.83), and better quality of life (β = 0.12; 95% CI, 0.00-0.24) compared with those who did not participate in CR. Our results explained that, capacity for stationary CR referral is low in the country. Therefore, we consider it of high importance to combine with various long term actionable preventive strategies. We leveraged our study by questioning how patient’s compliance to a physician’s lifestyle information is essential in chronic coronary syndrome (CCS). Assessing the characteristics associated with a patient’s recollection of physician information and lifestyle changes could elucidate the importance of individual tailoring of preventive interventions. Finally, we proposed an integrated approach for risk factor management in chronic coronary syndrome patients. Following that, an interaction between patient and physician is a fundamental approach for better adherence for CVD risk factor control. Cardiac rehabilitation program should be integrated and discussed during patient-physician consultation when deciding preventive strategies.