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Wallner, S; Watzinger, N; Lindschinger, M; Smolle, KH; Toplak, H; Eber, B; Dittrich, P; Elmadfa, I; Klein, W; Krejs, GJ; Wascher, TC.
Effects of intensified lifestyle modification on the need for further revascularization after coronary angioplasty.
Eur J Clin Invest. 1999; 29(5):372-379 Doi: 10.1046/j.1365-2362.1999.00456.x
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Leading authors Med Uni Graz: Holasek Sandra Johanna; Wascher Thomas
Co-authors Med Uni Graz: Klein Werner; Krejs Günter Josef; Smolle Karl-Heinz; Toplak Hermann; Watzinger Norbert
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Abstract:: Background In patients with coronary artery disease (CAD), a rate of restenosis as high as 50% is observed after percutaneous transluminal coronary angioplasty (PTCA). Frequently, this results in further revascularization procedures. Lifestyle intervention has been shown to slow the progression of CAD and to reduce cardiovascular events after myocardial infarction. However, no information exists whether such treatment influences the rate of restenosis in patients with CAD. The present study was performed to investigate the effects of an intensified lifestyle intervention on the need for further revascularization procedures in patients with established CAD after successful PTCA. Design A total of 60 patients were included and randomized to either conventional treatment by cardiologists and general practitioners or additional intensified lifestyle intervention in a diabetes and metabolism outpatient clinic for 12 months. The mean observation time after successful PTCA was 26 months. The primary outcome variable was the need for further revascularization procedures because of clinical restenosis. Secondary outcome variables were lifestyle-related measures. Results Intervention resulted in a reduction in body weight and blood pressure, and in increased physical activity. Furthermore, nutritional habits were changed towards less fat intake, and body composition changed towards a higher proportion of fat-free mass. The need for further revascularization procedures was reduced from a total of 14 out of 32 in the conventionally treated group to 3 out of 28 in the intervention group. This resulted in an event-free survival probability of 0.89 in the intervention group and 0.57 in the control group (P = 0.0055, log rank) with a resulting relative risk of 0.26 (95% CI 0.09-0.74). Conclusion In conclusion, our data strongly suggest that intensified lifestyle modification is able to reduce the need for further revascularization procedures after PTCA in patients with CAD.
Find related publications in this database (using NLM MeSH Indexing): Angina Pectoris - diet therapy Angina Pectoris - therapy; Angioplasty, Balloon, Coronary -; Coronary Artery Disease - diet therapy Coronary Artery Disease - prevention and control; Coronary Disease - diet therapy Coronary Disease - therapy; Disease-Free Survival -; Exercise -; Female -; Follow-Up Studies -; Health Behavior -; Humans -; Intervention Studies -; Life Style -; Linear Models -; Male -; Middle Aged -; Myocardial Revascularization -; Prospective Studies -; Recurrence - prevention and control; Risk Assessment -
Find related publications in this database (Keywords): Angioplasty; Coronary Artery Disease; Life-Style Modification; Restenosis