@article{SalzwedelVoellerReibisetal.2018, author = {Salzwedel, Annett and Voeller, Heinz and Reibis, Robert and Bonaventura, Klaus and Behrens, Steffen and Reibis, Rona Katharina}, title = {Regionale Versorgungsaspekte des akuten Myokardinfarktes im Nordosten Deutschlands}, series = {Deutsche medizinische Wochenschrift : DMW ; Organ der Deutschen Gesellschaft f{\"u}r Innere Medizin (DGIM) ; Organ der Gesellschaft Deutscher Naturforscher und {\"A}rzte (GDN{\"A})}, volume = {143}, journal = {Deutsche medizinische Wochenschrift : DMW ; Organ der Deutschen Gesellschaft f{\"u}r Innere Medizin (DGIM) ; Organ der Gesellschaft Deutscher Naturforscher und {\"A}rzte (GDN{\"A})}, number = {8}, publisher = {Thieme}, address = {Stuttgart}, issn = {0012-0472}, doi = {10.1055/s-0043-123907}, pages = {E51 -- E58}, year = {2018}, abstract = {Background In recent decades, guideline-based therapy of myocardial infarction has led to a considerable reduction in myocardial infarction mortality. However, there are relevant differences in acute care and the extent of infarction mortality. The objective of this survey was to analyze the current care situation of patients with acute myocardial infarction in the region of northeast Germany (Berlin, Brandenburg and Mecklenburg-Vorpommern). Methods Based on pseudonymized data from a statutory health insurance of 1 387 084 persons, a total of 6733 patients with inpatient admission at MI were filtered using the ICD10 code I21 and I22 for 2012. Total inhospital mortality and 1-year mortality and prognostic parameters were evaluated and analyzed in country comparisons. Results Both the hospital mortality rate and the 1-year mortality rate of the individual countries (Berlin 13.6 resp. 27.5 \%, respectively, BRB 13.9 and 27.9 \%, MV 14.4 and 29.0 \%, respectively) were comparable to the overall rate (13.9 \% or 28.0 \%) and in the country comparison. In the multiple analysis, the 1-year mortality was determined by the invasive strategy (OR 0.42, 95 \% CI 0.35 -0.51, p < 0.001) as well as by the implementation of the guidelines-based secondary prevention (OR 0.14, 95 \% CI 0.12 - 0.17, p < 0.001). There were no statistical differences between the three federal states. Conclusion The investigated population of patients with acute MI in Berlin, Brandenburg and Mecklenburg-Vorpommern demonstrated a comparable inpatient and post-hospital care and 1-year prognosis regardless of the federal state assignment. Referral to coronary angiography and adequate implementation of evidence-based medication demonstrated a significant prognostic impact.}, language = {de} } @misc{HansenNiebauerCornelissenetal.2018, author = {Hansen, Dominique and Niebauer, Josef and Cornelissen, Veronique and Barna, Olga and Neunhaeuserer, Daniel and Stettler, Christoph and Tonoli, Cajsa and Greco, Eugenio and Fagard, Robert and Coninx, Karin and Vanhees, Luc and Piepoli, Massimo F. and Pedretti, Roberto and Ruiz, Gustavo Rovelo and Corra, Ugo and Schmid, Jean-Paul and Davos, Constantinos H. and Edelmann, Frank and Abreu, Ana and Rauch, Bernhard and Ambrosetti, Marco and Braga, Simona Sarzi and Beckers, Paul and Bussotti, Maurizio and Faggiano, Pompilio and Garcia-Porrero, Esteban and Kouidi, Evangelia and Lamotte, Michel and Reibis, Rona Katharina and Spruit, Martijn A. and Takken, Tim and Vigorito, Carlo and V{\"o}ller, Heinz and Doherty, Patrick and Dendale, Paul}, title = {Exercise prescription in patients with different combinations of cardiovascular disease risk factors}, series = {Sports medicine}, volume = {48}, journal = {Sports medicine}, number = {8}, publisher = {Springer}, address = {Northcote}, issn = {0112-1642}, doi = {10.1007/s40279-018-0930-4}, pages = {1781 -- 1797}, year = {2018}, abstract = {Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice \& Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient.}, language = {en} } @phdthesis{Reibis2015, author = {Reibis, Robert Alexander}, title = {Regionale Versorgungsaspekte des aktuten Myokardinfarktes im Nordosten Deutschlands}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-85713}, school = {Universit{\"a}t Potsdam}, pages = {VI, 92}, year = {2015}, abstract = {Hintergrund: In Deutschland stellt der akute Myokardinfarkt (MI) eine der h{\"a}ufigsten Todesursachen dar. Als Ursache f{\"u}r regionale Unterschiede bei den Mortalit{\"a}tsraten werden divergente Versorgungsstrukturen vermutet. Ziel der Untersuchung war, diese Fragestellung anhand anonymisierter krankenkassenbasierter Abrechnungsdaten zu evaluieren. Methodik: Standardisierte Hospitalisierungs- sowie Krankenhaus- und Ein-Jahres-Mortalit{\"a}tsraten nach MI wurden anhand anonymisierter Versichertendaten einer gesetzlichen Krankenkasse f{\"u}r das Jahr 2012 und die Bundesl{\"a}nder Berlin, Brandenburg und Mecklenburg-Vorpommern ermittelt (n=1.387.084, 46.3\% male, 60.9 ± 18,2 years). Weiterhin wurden pr{\"a}diktive Einflussfaktoren auf die Ein-Jahres-Mortalit{\"a}t, auf die Durchf{\"u}hrung invasiver Prozeduren und auf eine leitliniengerechte pharmakotherapeutische Sekund{\"a}rpr{\"a}vention analysiert. Ergebnisse: 6.733 Patienten (73,7 ±13,0 Jahre, 56,7\% m{\"a}nnlich) wurden identifiziert. Obwohl f{\"u}r das Bundesland Berlin eine h{\"o}here Hospitalisierungsrate als in Mecklenburg-Vorpommern ermittelt werden konnte, ließen sich bei der Krankenhaus- und 1-Jahres-Mortalit{\"a}t keine signifikant abweichenden Raten zwischen den Bundesl{\"a}ndern beobachten. Die Durchf{\"u}hrung einer Koronarangiographie (OR: 0,42 [0,35-0,51]) und eine leitliniengerechte Pharmakotherapie (OR: 0,14 [0,12-0,17] waren mit einer geringeren 1-Jahres-Mortalit{\"a}t assoziiert. Die Durchf{\"u}hrung einer Koronarangiographie und eine leitliniengerechte Pharmakotherapie von Patienten nach Myokardinfarkt wurde hingegen prim{\"a}r durch Alter und Geschlecht, nicht aber durch das Bundesland determiniert. Folgerung: Eine regional divergierende station{\"a}re und postinfarzielle Versorgung auf Bundesland-Ebene kann anhand der vorliegenden Daten nicht nachgewiesen werden.}, language = {de} } @article{HansenDendaleConinxetal.2017, author = {Hansen, Dominique and Dendale, Paul and Coninx, Karin and Vanhees, Luc and Piepoli, Massimo F. and Niebauer, Josef and Cornelissen, Veronique and Pedretti, Roberto and Geurts, Eva and Ruiz, Gustavo R. and Corra, Ugo and Schmid, Jean-Paul and Greco, Eugenio and Davos, Constantinos H. and Edelmann, Frank and Abreu, Ana and Rauch, Bernhard and Ambrosetti, Marco and Braga, Simona S. and Barna, Olga and Beckers, Paul and Bussotti, Maurizio and Fagard, Robert and Faggiano, Pompilio and Garcia-Porrero, Esteban and Kouidi, Evangelia and Lamotte, Michel and Neunhaeuserer, Daniel and Reibis, Rona Katharina and Spruit, Martijn A. and Stettler, Christoph and Takken, Tim and Tonoli, Cajsa and Vigorito, Carlo and V{\"o}ller, Heinz and Doherty, Patrick}, title = {The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {24}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, publisher = {Sage Publ.}, address = {London}, issn = {2047-4873}, doi = {10.1177/2047487317702042}, pages = {1017 -- 1031}, year = {2017}, abstract = {Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases.}, language = {en} }