Gender-specific secondary prevention? Differential psychosocial risk factors for major cardiovascular events
Journal article
Kure, Christina, Chan, Kai, Ski, Chantal, Thompson, David, Carrington, Melinda and Stewart, Simon. (2016). Gender-specific secondary prevention? Differential psychosocial risk factors for major cardiovascular events. Open Heart (online). 3(1), pp. 1 - 8. https://doi.org/10.1136/openhrt-2015-000356
Authors | Kure, Christina, Chan, Kai, Ski, Chantal, Thompson, David, Carrington, Melinda and Stewart, Simon |
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Abstract | Objective: To explore the psychosocial determinants and interhospital variability on a major acute cardiovascular event (MACE), during follow-up of a multicenter cohort of patients hospitalised with heart disease, participating in a nurse-led secondary prevention programme. Methods: Outcome data were retrospectively analysed from 602 cardiac inpatients randomised to postdischarge standard care (n=296), or home-based intervention (n=306), with prolonged follow-up of individualised multidisciplinary support. Baseline psychosocial profiling comprised depressive status, health-related quality of life (HRQoL), social isolation and mild cognitive impairment (MCI). Multivariate analyses examined the independent correlates of a composite 2-year MACE rate of all-cause mortality and unplanned cardiovascular-related hospitalisation, according to gender. Results: Participants were aged 70±10 years, 431 (72%) were men and 377 (63%) had coronary artery disease. During 2-year follow-up, 165 (27%) participants (114 men, 51 women; p=0.431) experienced a MACE. Independent correlates of a MACE in men were depressive status (OR 1.95, 95% CI 1.06 to 3.58; p=0.032), low physical HRQoL (OR 0.98, 95% CI 0.96 to 1.00; p=0.027) and increasing comorbidity (OR 1.14, 95% CI 1.04 to 1.25; p=0.004). In women, age (OR 1.06, 95% CI 1.02 to 1.12; p=0.008), MCI (OR 2.38, 95% CI 1.09 to 5.18; p=0.029) and hospital site predicted a MACE (OR 2.32, 95% CI 1.09 to 4.93; p=0.029). Conclusions: Psychological determinants, cognitive impairment and responses to secondary prevention are different for men and women with heart disease and appear to modulate cardiovascular-specific outcomes. Early detection of psychosocial factors through routine screening and gender-specific secondary prevention is encouraged. |
Year | 2016 |
Journal | Open Heart (online) |
Journal citation | 3 (1), pp. 1 - 8 |
Publisher | B M J Group |
ISSN | 2053-3624 |
Digital Object Identifier (DOI) | https://doi.org/10.1136/openhrt-2015-000356 |
Open access | Open access |
Page range | 1 - 8 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | License |
Place of publication | United Kingdom |
Editors | P. Meier |
https://acuresearchbank.acu.edu.au/item/8q655/gender-specific-secondary-prevention-differential-psychosocial-risk-factors-for-major-cardiovascular-events
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Kure_2016_Gender_specific_secondary_prevention_differential_psychosocial.pdf | |
License: CC BY-NC 4.0 |
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