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Determinants of risk factor target attainment after myocardial infarction: the Perfect-CR study
Landspitali Univ Hosp, Iceland; Lund Univ, Sweden.
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
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2026 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2026.
Keywords [en]
Cardiac rehabilitation; Myocardial infarction; Risk factors; Secondary prevention
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:liu:diva-226674DOI: 10.1093/eurjcn/zvag149ISI: 001815078100001PubMedID: 42418342OAI: oai:DiVA.org:liu-226674DiVA, id: diva2:2093300
Note

Funding Agencies|Swedish Cardiology Society; Amgen; Astra Zeneca; Swedish Heart and Lung Association [20190431]; faculty of Medicine; Lund University; Swedish Heart and Lung Patient Organisation; Swedish Research Council for Health, Working Life and Welfare [2019-00365]; Swedish Heart-Lung Foundation [20190431] Funding Source: Swedish Heart-Lung Foundation

Available from: 2026-08-18 Created: 2026-08-18 Last updated: 2026-08-18

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