| Physical function and independence 1 year after myocardial infarction: observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry. | |
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MedLine Citation:
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PMID: 22607856 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Acute myocardial infarction (AMI) may contribute to health status declines including "independence loss" and "physical function decline." Despite the importance of these outcomes for prognosis and quality of life, their incidence and predictors have not been well described. METHODS: We studied 2,002 patients with AMI enrolled across 24 sites in the TRIUMPH registry who completed assessments of independence and physical function at the time of AMI and 1 year later. Independence was evaluated by the EuroQol-5D (mobility, self-care, and usual activities), and physical function was assessed with the Short Form-12 physical component score. Declines in ≥1 level on EuroQol-5D and >5 points in PCS were considered clinically significant changes. Hierarchical, multivariable, modified Poisson regression models accounting for within-site variability were used to identify predictors of independence loss and physical function decline. RESULTS: One-year post AMI, 43.0% of patients experienced health status declines: 12.8% independence loss alone, 15.2% physical function decline alone, and 15.0% both. After adjustment, variables that predicted independence loss included female sex, nonwhite race, unmarried status, uninsured status, end-stage renal disease, and depression. Variables that predicted physical function decline were uninsured status, lack of cardiac rehabilitation referral, and absence of pre-AMI angina. Age was not predictive of either outcome after adjustment. CONCLUSIONS: >40% of patients experience independence loss or physical function decline 1 year after AMI. These changes are distinct but can occur simultaneously. Although some risk factors are not modifiable, others suggest potential targets for strategies to preserve patients' health status. |
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Authors:
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John A Dodson; Suzanne V Arnold; Kimberly J Reid; Thomas M Gill; Michael W Rich; Frederick A Masoudi; John A Spertus; Harlan M Krumholz; Karen P Alexander |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 163 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-05-21 Completed Date: 2012-07-31 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 790-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Section of Cardiology, Yale University School of Medicine, New Haven, CT 06520, USA. john.dodson@yale.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Activities of Daily Living Age Factors Aged Angioplasty, Balloon, Coronary / adverse effects, methods* Attitude to Health* Cardiac Catheterization / methods Coronary Angiography / methods Depression / epidemiology, etiology, physiopathology Electrocardiography / methods Female Follow-Up Studies Health Surveys Humans Incidence Independent Living / statistics & numerical data* Male Middle Aged Multivariate Analysis Myocardial Infarction / complications, radiography, therapy* Physical Fitness / physiology* Poisson Distribution Predictive Value of Tests Quality of Life Questionnaires Registries* Risk Assessment Sickness Impact Profile Survivors Time Factors Translational Medical Research |
| Grant Support | |
ID/Acronym/Agency:
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P50 HL077113/HL/NHLBI NIH HHS; T32 AG019134/AG/NIA NIH HHS; T32 AG019134-11/AG/NIA NIH HHS |
| Comments/Corrections | |
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