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Aspects on coronary heart disease prevention in clinical practice

Stagmo, Martin LU (2005) In Doctoral dissertation series 2005:68
Abstract
Prevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the... (More)
Prevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the end of the programme. A quality control system based on patient empowerment and education with continuous feedback to patients, nurses and physicians seemed to be welcomed by both patients and participating health care professionals. However, our system based on voluntary participation and report cards did not seem to be feasible at this time due to a high dropout rate. Reasons why targets for serum lipids were not met in the EUROASPIRE II study were that too few patients received lipid-lowering drugs, and that of those who did receive such treatment many were treated with sub-optimal doses. Ambulatory ECG with ST-analysis could add significant information on which healthy subjects with a certain accumulation of risk factors who would suffer from a major coronary event (death, AMI or revascularisation) over a 15-year time period. (Less)
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author
supervisor
opponent
  • Professor Rydén, Lars, Karolinska Institutet, Stockholm
organization
publishing date
type
Thesis
publication status
published
subject
keywords
prevention, Kardiovaskulära systemet, Cardiovascular system, Medicin (människa och djur), Medicine (human and vertebrates), nurse-led clinics, risk stratification, Implementation, Coronary hert disease
in
Doctoral dissertation series 2005:68
pages
49 pages
publisher
Lund University, Faculty of Medicine
defense location
Universitetssjukhuset MAS, Aulan Ingång 35
defense date
2005-10-14 13:00
ISSN
1652-8220
ISBN
91-85439-72-X
language
English
LU publication?
yes
id
5dbe9cf3-ddbe-4c85-8c5d-721ff6406b11 (old id 1132799)
date added to LUP
2008-06-23 16:27:11
date last changed
2016-09-19 08:44:57
@phdthesis{5dbe9cf3-ddbe-4c85-8c5d-721ff6406b11,
  abstract     = {Prevention of first time disease or recurrence of coronary heart disease (CHD) is a major task for the health service. Guidelines regarding CHD prevention have been issued but studies have shown that treatment goals are inadequately met in clinical practice and there is urgent need for improved methods of implementation of guidelines. There is also a need for better risk stratification tools in order to identify asymptomatic subjects with a high risk for future CHD. This thesis has shown that: A structured, one-year, hospital-based secondary prevention programme after CHD, mainly led by specialist nurses with physician backup, could positively influence the use of lipid-lowering drugs and serum cholesterol levels several years after the end of the programme. A quality control system based on patient empowerment and education with continuous feedback to patients, nurses and physicians seemed to be welcomed by both patients and participating health care professionals. However, our system based on voluntary participation and report cards did not seem to be feasible at this time due to a high dropout rate. Reasons why targets for serum lipids were not met in the EUROASPIRE II study were that too few patients received lipid-lowering drugs, and that of those who did receive such treatment many were treated with sub-optimal doses. Ambulatory ECG with ST-analysis could add significant information on which healthy subjects with a certain accumulation of risk factors who would suffer from a major coronary event (death, AMI or revascularisation) over a 15-year time period.},
  author       = {Stagmo, Martin},
  isbn         = {91-85439-72-X},
  issn         = {1652-8220},
  keyword      = {prevention,Kardiovaskulära systemet,Cardiovascular system,Medicin (människa och djur),Medicine (human and vertebrates),nurse-led clinics,risk stratification,Implementation,Coronary hert disease},
  language     = {eng},
  pages        = {49},
  publisher    = {Lund University, Faculty of Medicine},
  school       = {Lund University},
  series       = {Doctoral dissertation series 2005:68},
  title        = {Aspects on coronary heart disease prevention in clinical practice},
  year         = {2005},
}