Mortality in patients after acute myocardial infarction managed by cardiologists and primary care physicians : a systematic review

2020
journal article
article
7
cris.lastimport.wos2024-04-09T18:09:45Z
dc.abstract.enIntroduction Mortality following acute myocardial infarction (AMI) remains high despite of progress in invasive and noninvasive treatments. Objectives This study aimed to compare the outcomes of ambulatory treatment provided by cardiologists versus general practitioners (GPs) in post‑AMI patients. Patients and methods We conducted a systematic search in 3 electronic databases for interventional and observational studies that reported all‑cause mortality, mortality from cardiovascular causes, stroke, and myocardial infarction at long‑term follow‑up following AMI. We assessed the risk of bias of the included studies using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS‑I) tool. For randomized trials, we used the revised Cochrane risk of bias tool (RoB 2.0). Results Two nonrandomized studies fulfilled the inclusion criteria. We assessed these studies as having a moderate risk of bias. We did not pool the results owing to significant heterogeneity between the studies. Patients consulted by both a cardiologist and a GP were at lower risk of all‑cause death as compared with patients consulted by a cardiologist only (risk ratio [RR], 0.92; 95% CI, 0.85–0.99). Patients consulted by a cardiologist with or without GP consultation were at lower risk of all‑cause death compared with those consulted by a GP only in both studies (RR, 0.8; 95% CI, 0.75–0.85 and RR, 0.44; 95% CI, 0.41–0.47). Conclusions Patients after AMI consulted by both a cardiologist and a GP may beat lower risk of death compared with patients consulted by a GP or a cardiologist only. However, these findings are based on moderate‑quality nonrandomized studies. We found no evidence on the relation between the specialization of the physician and the risk of cardiovascular death, stroke, or myocardial infarction in AMI survivors.pl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.affiliationWydział Lekarski : Zakład Higieny i Dietetykipl
dc.cm.date2021-02-15
dc.cm.id100656
dc.contributor.authorPęksa, Janpl
dc.contributor.authorStorman, Dawid - 206005 pl
dc.contributor.authorJankowski, Piotr - 159981 pl
dc.contributor.authorStaśkiewicz, Wojciechpl
dc.contributor.authorJasińska, Katarzynapl
dc.contributor.authorCzarnecka, Danuta - 129092 pl
dc.contributor.authorBała, Małgorzata - 128647 pl
dc.date.accessioned2021-02-15T01:22:12Z
dc.date.available2021-02-15T01:22:12Z
dc.date.issued2020pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number10pl
dc.description.physical860-867pl
dc.description.points100
dc.description.versionostateczna wersja wydawcy
dc.description.volume130pl
dc.identifier.doi10.20452/pamw.15542pl
dc.identifier.eissn1897-9483pl
dc.identifier.issn0032-3772pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/263905
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.encardiologistpl
dc.subject.encoronary artery diseasepl
dc.subject.engeneral practitionerpl
dc.subject.enmortalitypl
dc.subject.enmyocardial infarctionpl
dc.subtypeArticlepl
dc.titleMortality in patients after acute myocardial infarction managed by cardiologists and primary care physicians : a systematic reviewpl
dc.title.journalPolskie Archiwum Medycyny Wewnętrznej = Polish Archives of Internal Medicinepl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T18:09:45Z
dc.abstract.enpl
Introduction Mortality following acute myocardial infarction (AMI) remains high despite of progress in invasive and noninvasive treatments. Objectives This study aimed to compare the outcomes of ambulatory treatment provided by cardiologists versus general practitioners (GPs) in post‑AMI patients. Patients and methods We conducted a systematic search in 3 electronic databases for interventional and observational studies that reported all‑cause mortality, mortality from cardiovascular causes, stroke, and myocardial infarction at long‑term follow‑up following AMI. We assessed the risk of bias of the included studies using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS‑I) tool. For randomized trials, we used the revised Cochrane risk of bias tool (RoB 2.0). Results Two nonrandomized studies fulfilled the inclusion criteria. We assessed these studies as having a moderate risk of bias. We did not pool the results owing to significant heterogeneity between the studies. Patients consulted by both a cardiologist and a GP were at lower risk of all‑cause death as compared with patients consulted by a cardiologist only (risk ratio [RR], 0.92; 95% CI, 0.85–0.99). Patients consulted by a cardiologist with or without GP consultation were at lower risk of all‑cause death compared with those consulted by a GP only in both studies (RR, 0.8; 95% CI, 0.75–0.85 and RR, 0.44; 95% CI, 0.41–0.47). Conclusions Patients after AMI consulted by both a cardiologist and a GP may beat lower risk of death compared with patients consulted by a GP or a cardiologist only. However, these findings are based on moderate‑quality nonrandomized studies. We found no evidence on the relation between the specialization of the physician and the risk of cardiovascular death, stroke, or myocardial infarction in AMI survivors.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.affiliationpl
Wydział Lekarski : Zakład Higieny i Dietetyki
dc.cm.date
2021-02-15
dc.cm.id
100656
dc.contributor.authorpl
Pęksa, Jan
dc.contributor.authorpl
Storman, Dawid - 206005
dc.contributor.authorpl
Jankowski, Piotr - 159981
dc.contributor.authorpl
Staśkiewicz, Wojciech
dc.contributor.authorpl
Jasińska, Katarzyna
dc.contributor.authorpl
Czarnecka, Danuta - 129092
dc.contributor.authorpl
Bała, Małgorzata - 128647
dc.date.accessioned
2021-02-15T01:22:12Z
dc.date.available
2021-02-15T01:22:12Z
dc.date.issuedpl
2020
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
10
dc.description.physicalpl
860-867
dc.description.points
100
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
130
dc.identifier.doipl
10.20452/pamw.15542
dc.identifier.eissnpl
1897-9483
dc.identifier.issnpl
0032-3772
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/263905
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
cardiologist
dc.subject.enpl
coronary artery disease
dc.subject.enpl
general practitioner
dc.subject.enpl
mortality
dc.subject.enpl
myocardial infarction
dc.subtypepl
Article
dc.titlepl
Mortality in patients after acute myocardial infarction managed by cardiologists and primary care physicians : a systematic review
dc.title.journalpl
Polskie Archiwum Medycyny Wewnętrznej = Polish Archives of Internal Medicine
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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