Factors associated with actively working in the very long-term following acute coronary syndrome

Detalhes bibliográficos
Autor(a) principal: Nicolau, José C.
Data de Publicação: 2021
Outros Autores: Furtado, Remo H.M., Dalçóquio, Talia F., Lara, Livia M., Juliasz, Marcela G., Ferrari, Aline G., Nakashima, Carlos A.K., Franci, Andre, Pereira, Cesar A. C., Lima, Felipe G., Giraldez, Roberto R., Salsoso, Rocío, Baracioli, Luciano M., Goodman, Shaun
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/191762
Resumo: OBJECTIVES: Returning to work after an episode of acute coronary syndrome (ACS) is challenging for many patients, and has both personal and social impacts. There are limited data regarding the working status in the very long-term after ACS. METHODS: We retrospectively analyzed 1,632 patients who were working prior to hospitalization for ACS in a quaternary hospital and were followed-up for up to 17 years. Adjusted models were developed to analyze the variables independently associated with actively working at the last contact, and a prognostic predictive index for not working at follow-up was developed. RESULTS: The following variables were significantly and independently associated with actively working at the last contact: age4median (hazard-ratio [HR], 0.76, po0.001); male sex (HR, 1.52, po0.001); government health insurance (HR, 1.36, po0.001); history of angina (HR, 0.69, po0.001) or myocardial infarction (MI) (HR, 0.76, p=0.005); smoking (HR, 0.81, p=0.015); ST-elevation MI (HR, 0.81, p=0.021); anterior-wall MI (HR, 0.75, p=0.001); non-primary percutaneous coronary intervention (PCI) (HR, 0.77, p=0.002); fibrinolysis (HR, 0.61, po0.001); cardiogenic shock (HR, 0.60, p=0.023); statin (HR, 3.01, po0.001), beta-blocker (HR, 1.26, p=0.020), angiotensinconverting enzyme (ACE) inhibitor/angiotensin II receptor blocker (ARB) (HR, 1.37, p=0.001) at hospital discharge; and MI at follow-up (HR, 0.72, p=0.001). The probability of not working at the last contact ranged from 24.2% for patients with no variables, up to 80% for patients with six or more variables. CONCLUSIONS: In patients discharged after ACS, prior and in-hospital clinical variables, as well as the quality of care at discharge, have a great impact on the long-term probability of actively working.
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spelling Factors associated with actively working in the very long-term following acute coronary syndromeLong-Term Post-Hospital DischargeReturn to WorkAcute Coronary SyndromeOBJECTIVES: Returning to work after an episode of acute coronary syndrome (ACS) is challenging for many patients, and has both personal and social impacts. There are limited data regarding the working status in the very long-term after ACS. METHODS: We retrospectively analyzed 1,632 patients who were working prior to hospitalization for ACS in a quaternary hospital and were followed-up for up to 17 years. Adjusted models were developed to analyze the variables independently associated with actively working at the last contact, and a prognostic predictive index for not working at follow-up was developed. RESULTS: The following variables were significantly and independently associated with actively working at the last contact: age4median (hazard-ratio [HR], 0.76, po0.001); male sex (HR, 1.52, po0.001); government health insurance (HR, 1.36, po0.001); history of angina (HR, 0.69, po0.001) or myocardial infarction (MI) (HR, 0.76, p=0.005); smoking (HR, 0.81, p=0.015); ST-elevation MI (HR, 0.81, p=0.021); anterior-wall MI (HR, 0.75, p=0.001); non-primary percutaneous coronary intervention (PCI) (HR, 0.77, p=0.002); fibrinolysis (HR, 0.61, po0.001); cardiogenic shock (HR, 0.60, p=0.023); statin (HR, 3.01, po0.001), beta-blocker (HR, 1.26, p=0.020), angiotensinconverting enzyme (ACE) inhibitor/angiotensin II receptor blocker (ARB) (HR, 1.37, p=0.001) at hospital discharge; and MI at follow-up (HR, 0.72, p=0.001). The probability of not working at the last contact ranged from 24.2% for patients with no variables, up to 80% for patients with six or more variables. CONCLUSIONS: In patients discharged after ACS, prior and in-hospital clinical variables, as well as the quality of care at discharge, have a great impact on the long-term probability of actively working.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2021-11-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/19176210.6061/clinics/2021/e2553Clinics; Vol. 76 (2021); e2553Clinics; v. 76 (2021); e2553Clinics; Vol. 76 (2021); e25531980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/191762/176657Copyright (c) 2021 Clinicsinfo:eu-repo/semantics/openAccessNicolau, José C. Furtado, Remo H.M. Dalçóquio, Talia F. Lara, Livia M. Juliasz, Marcela G. Ferrari, Aline G. Nakashima, Carlos A.K. Franci, Andre Pereira, Cesar A. C. Lima, Felipe G. Giraldez, Roberto R. Salsoso, Rocío Baracioli, Luciano M. Goodman, Shaun 2023-07-06T13:04:01Zoai:revistas.usp.br:article/191762Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:04:01Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Factors associated with actively working in the very long-term following acute coronary syndrome
title Factors associated with actively working in the very long-term following acute coronary syndrome
spellingShingle Factors associated with actively working in the very long-term following acute coronary syndrome
Nicolau, José C.
Long-Term Post-Hospital Discharge
Return to Work
Acute Coronary Syndrome
title_short Factors associated with actively working in the very long-term following acute coronary syndrome
title_full Factors associated with actively working in the very long-term following acute coronary syndrome
title_fullStr Factors associated with actively working in the very long-term following acute coronary syndrome
title_full_unstemmed Factors associated with actively working in the very long-term following acute coronary syndrome
title_sort Factors associated with actively working in the very long-term following acute coronary syndrome
author Nicolau, José C.
author_facet Nicolau, José C.
Furtado, Remo H.M.
Dalçóquio, Talia F.
Lara, Livia M.
Juliasz, Marcela G.
Ferrari, Aline G.
Nakashima, Carlos A.K.
Franci, Andre
Pereira, Cesar A. C.
Lima, Felipe G.
Giraldez, Roberto R.
Salsoso, Rocío
Baracioli, Luciano M.
Goodman, Shaun
author_role author
author2 Furtado, Remo H.M.
Dalçóquio, Talia F.
Lara, Livia M.
Juliasz, Marcela G.
Ferrari, Aline G.
Nakashima, Carlos A.K.
Franci, Andre
Pereira, Cesar A. C.
Lima, Felipe G.
Giraldez, Roberto R.
Salsoso, Rocío
Baracioli, Luciano M.
Goodman, Shaun
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Nicolau, José C.
Furtado, Remo H.M.
Dalçóquio, Talia F.
Lara, Livia M.
Juliasz, Marcela G.
Ferrari, Aline G.
Nakashima, Carlos A.K.
Franci, Andre
Pereira, Cesar A. C.
Lima, Felipe G.
Giraldez, Roberto R.
Salsoso, Rocío
Baracioli, Luciano M.
Goodman, Shaun
dc.subject.por.fl_str_mv Long-Term Post-Hospital Discharge
Return to Work
Acute Coronary Syndrome
topic Long-Term Post-Hospital Discharge
Return to Work
Acute Coronary Syndrome
description OBJECTIVES: Returning to work after an episode of acute coronary syndrome (ACS) is challenging for many patients, and has both personal and social impacts. There are limited data regarding the working status in the very long-term after ACS. METHODS: We retrospectively analyzed 1,632 patients who were working prior to hospitalization for ACS in a quaternary hospital and were followed-up for up to 17 years. Adjusted models were developed to analyze the variables independently associated with actively working at the last contact, and a prognostic predictive index for not working at follow-up was developed. RESULTS: The following variables were significantly and independently associated with actively working at the last contact: age4median (hazard-ratio [HR], 0.76, po0.001); male sex (HR, 1.52, po0.001); government health insurance (HR, 1.36, po0.001); history of angina (HR, 0.69, po0.001) or myocardial infarction (MI) (HR, 0.76, p=0.005); smoking (HR, 0.81, p=0.015); ST-elevation MI (HR, 0.81, p=0.021); anterior-wall MI (HR, 0.75, p=0.001); non-primary percutaneous coronary intervention (PCI) (HR, 0.77, p=0.002); fibrinolysis (HR, 0.61, po0.001); cardiogenic shock (HR, 0.60, p=0.023); statin (HR, 3.01, po0.001), beta-blocker (HR, 1.26, p=0.020), angiotensinconverting enzyme (ACE) inhibitor/angiotensin II receptor blocker (ARB) (HR, 1.37, p=0.001) at hospital discharge; and MI at follow-up (HR, 0.72, p=0.001). The probability of not working at the last contact ranged from 24.2% for patients with no variables, up to 80% for patients with six or more variables. CONCLUSIONS: In patients discharged after ACS, prior and in-hospital clinical variables, as well as the quality of care at discharge, have a great impact on the long-term probability of actively working.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-09
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191762
10.6061/clinics/2021/e2553
url https://www.revistas.usp.br/clinics/article/view/191762
identifier_str_mv 10.6061/clinics/2021/e2553
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191762/176657
dc.rights.driver.fl_str_mv Copyright (c) 2021 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2021 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 76 (2021); e2553
Clinics; v. 76 (2021); e2553
Clinics; Vol. 76 (2021); e2553
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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