Determinants of risk factor target attainment after myocardial infarction: the Perfect-CR study

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ID: 319904
2026
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Ranked #45 of 46 articles by views in european journal of cardiovascular nursing : journal of the working group on cardiovascular nursing of the european society of cardiology

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Abstract
Abstract Aims How individual components of cardiac rehabilitation (CR) programmes predict attainment of risk factor targets after myocardial infarction (MI), and their predictive strength relative to patient characteristics, remain unclear. We aimed to identify organizational and patient-level predictors of risk factor target attainment at 1-year post-MI. Methods and results Organizational structure and processes followed at all 78 CR centres in Sweden were surveyed and merged with patient-level registry data (n = 6755). Predictors of attaining low-density lipoprotein-cholesterol (LDL-C) and blood pressure (BP) targets and smoking abstinence were identified using orthogonal partial least squares discriminant analysis, generating variables of importance for the projection (VIP) values. Variables with VIP > 0.8 were considered meaningful. The strongest predictors for attaining LDL-C and BP targets included availability of psychosocial management, medication adjustment protocols for nurses, continuity in nurse-patient contact, extended opening hours and adequate facilities, and having a medical director at the CR centre. The strongest patient-level predictors of attaining LDL-C and/or BP targets included low baseline LDL-C and having no history of hypertension, respectively, and the patient having participated in exercise-based CR. For smoking abstinence, the strongest organizational predictors were availability of psychosocial management, having a medical director, prescribing nicotine replacement therapy and varenicline, and self-reported team spirit. Patient-level predictors included having participated in exercise-based CR and group education. Conclusion We identified multiple CR organizational predictors of attaining key risk factor targets after MI. These results may influence the future design of comprehensive CR programmes.
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Authors Halldóra Ögmundsdóttir Michelsen, Peter Henriksson, John Wallert, Maria Bäck, Ingela Sjölin, Mona Schlyter, Emil Hagström, Anna Kiessling, Claes Held, Emma Hag, Lennart Nilsson, Alexandru Șchiopu, Margrét Leósdóttir
Journal european journal of cardiovascular nursing : journal of the working group on cardiovascular nursing of the european society of cardiology
Year 2026
DOI
10.1093/eurjcn/zvag149
URL
Keywords Keywords not found

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