Secondary Prevention in Coronary Artery Disease and Myocardial Infarction

331 Pages·1985·8.88 MB·English

by  R. Mulcahy (auth.)

SECONDARY PREVENTION IN CORONARY ARTERY DISEASE AND
MYOCARDIAL INFARCTION
DEVELOPMENTS IN
CARDIOVASCULAR MEDICINE
Lancee CT, ed: Echocardiology, 1979. ISBN 90-247-2209-8.
Baan J, Arntzenius AC, Yellin EL, eds: Cardiac dynamics. 1980. ISBN 90-247-2212-8.
Thalen HJT, Meere CC, eds: Fundamentals of cardiac pacing. 1970. ISBN 90-247-2245-4.
Kulbertus HE, Wellens H11, eds: Sudden death. 1980. ISBN 90-247-2290-X.
Dreifus LS, Brest AN, eds: Clinical applications of cardiovascular drugs. 1980. ISBN 90-247-2295-0.
Spencer MP, Reid JM, eds: Cerebrovascular evaluation with Doppler ultrasound. 1981. ISBN 90-247-2348-1.
Zipes DP, Bailey JC, Elharrar V, eds: The slow inward current and cardiac arrhythmias. 1980. ISBN 90-247-2380-9.
Kesteloot H, Joossens JV, eds: Epidemiology of arterial blood pressure. 1980. ISBN 90-247-2386-8.
Wackers FJT, ed: Thallium-201 and technetium-99m-pyrophosphate myocardial imaging in the coronary care unit.
1980. ISBN 90-247-2396-5.
Maseri A, Marchesi C, Chierchia S, Trivella MG, eds: Coronary care units. 1981. ISBN 90-247-2456-2.
Morganroth J, Moore EN, Dreifus LS, Michelson EL, eds: The evaluation of new antiarrhythmic drugs. 1981.
ISBN 90-247-2474-0.
Alboni P: Intraventricular conduction disturbances. 1981. ISBN 90-247-2484-X.
Rijsterborgh H, ed: Echocardiology. 1981. ISBN 90-247-2491-0.
Wagner GS, ed: Myocardial infarction: Measurement and intervention. 1982. ISBN 90-247-2513-5.
Meltzer RS, Roelandt J, eds: Contrast echocardiography. 1982. ISBN 90-247-2531-3.
Amery A, Fagard R, Lijnen R, Staessen J, eds: Hypertensive cardiovascular disease; pathophysiology and treatment.
1982. ISBN 90-247-2534-8.
Bouman LN, Jongsma HJ, eds: Cardiac rate and rhythm. 1982. ISBN 90-247-2626-3.
Morganroth J, Moore EN, eds: The evaluation of beta blocker and calcium antagonist drugs. 1982.
ISBN 90-247-2642-5.
Rosenbaum MB, ed: Frontiers of cardiac electrophysiology. 1982. ISBN 90-247-2663-8.
Roelandt J, Hugenholtz PG, eds: Long-term ambulatory electrocardiography. 1982. ISBN 90-247-2664-8.
Adgey AAJ, ed: Acute phase of ischemic heart disease and myocardial infarction. 1982. ISBN 90-247-2675-1.
Hanrath P, Bleifeld W, Souquet, J. eds: Cardiovascular diagnosis by ultrasound. Transesophageal, computerized,
contrast, Doppler echocardiography. 1982. ISBN 90-247-2692-1.
Roelandt J, ed: The practice of M-mode and two-dimensional echocardiography. 1983. ISBN 90-247-2745-6.
Meyer J, Schweizer P, Erbel R, eds: Advances in noninvasive cardiology. 1983. ISBN 0-89838-576-8.
Morganroth J, Moore EN, eds: Sudden cardiac death and congestive heart failure: Diagnosis and treatment. 1983.
ISBN 0-89838-580-6.
Perry HM, ed: Lifelong management of hypertension. 1983. ISBN 0-89838-582-2.
Jaffe EA, ed: Biology of endothelial cells. 1984. ISBN 0-89838-587-3.
Surawicz B, Reddy CP, Prystowsky EN, eds: Tachycardias. ISBN 0-89838-588-1.
Spencer MP, ed: Cardiac Doppler diagnosis. 1983. ISBN 0-89838-591-1.
Villarreal H, Sambhi MP, eds: Topics in pathophysiology of hypertension. 1984. ISBN 0-89838-595-4.
Messerli FH, ed: Cardiovascular disease in the elderly. 1984. ISBN 0-89838-596-2.
Simoons ML, Reiber JHC, eds: Nuclear imaging in clinical cardiology. 1984. ISBN 0-89838-599-7.
Ter Keurs HEDJ, Schipperheyn 11, eds: Cardiac left ventricular hypertrophy. 1983. ISBN 0-89838-612-8.
Sperelakis N, ed: Physiology and pathophysiology of the heart. ISBN 0-89838-615-2.
Messerli FH, ed: Kidney in essential hypertension. ISBN 0-89838-616-0.
Sambhi MP, ed: Fundamental fault in hypertension. ISBN 0-89838-638-1.
Marchesi C, ed: Ambulatory monitoring: Cardiovascular system and allied applications. ISBN 0-89838-642-X.
Kupper W, MacAlpin RN, Bleifeld W, eds: Coronary tone in ischemic heart disease. ISBN 0-89838-646-2.
Sperelakis N, Caulfield JB, eds: Calcium antagonists: Mechanisms of action on cardiac muscle and vascular smooth
muscle. ISBN 0-89838-655-1.
Godfraind T, Herman AS, Wellens 0, eds: Calcium entry blockers in cardiovascular and cerebral dysfunctions.
ISBN 0-89838-658-6.
Morganroth J, Moore EN, eds: Interventions in the acute phase of myocardial infarction. ISBN 0-89838-659-4.
Abel FL, Newman WH, eds: Functional aspects of the normal, hypertrophied, and failing heart. ISBN 0-89838-665-9.
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Van der Wall E, Lie KI, eds: Recent views on hypertrophic cardiomyopathy. ISBN 0-89838-694-2.
Mathes E, ed: Secondary prevention in coronary artery disease and myocardial infarction. 1985. ISBN 0-89838-736-1.
SECONDARY PREVENTION
IN CORONARY ARTERY
DISEASE AND MYOCARDIAL
INFARCTION
edited by
PETER MATHES
Klinik Hohenried, Center for Cardiac Rehabilitation, Bernried (Obb.),
and Technical University of Munich
Medical School, Munich, Federal Republic of Germany
1985 MARTINUS NIJHOFF PUBLISHERS
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON / THE HAGUE / DORDRECHT / LANCASTER
Distributors
for the United States and Canada: Kluwer Academic Publishers, 190 Old Derby
Street, Hingham, MA 02043, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LAI 1RN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Main entry under title:
Secondary prevention in coronary artery disease
and myocardial infarction.
(Developments in cardiovascular medicine)
Includes index.
1. Coronary heart disease--Prevention. 2. Heart-
lnfarction--Prevention. 3. Coronary heart disease-
TreaLment. 4. Heart--Infarction-~Treatment. I. Mathes,
P. (Peter), 1940- II. Series. [DNLM: 1. Coronary
Disease--prevention & control. 2. Myocardial
Infarction--prevention & control.
WI DE997VME / WG 300 S4445J
RC685.C6S42 1985 616.1'2305 85-8954
ISBN-13: 978-94-010-8725-4 e-ISBN-13: 978-94-009-5024-5
001: 10.1007/978-94-009-5024-5
Copyright
© 1985 by Martinus Nijhoff Publishers, Dordrecht.
Softcover reprint of the hardcover I st edition 1985
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht,
The Netherlands.
v
Preface
Despite considerable effort in primary prevention, coronary heart disease
continues to be the leading cause of death in the industrialized nations. The
patient who survives his first myocardial infarction carries approximately a
tenfold risk of recurrence and sudden death when compared to the normal
population. The concept of secondary prevention, therefore, has emerged as
an active strategy aimed at the reduction of fatal and non-fatal recurrences
of myocardial infarction. Apart from risk factors of relevance in primary
prevention, secondary prevention is dependent on the extent of the disease
itself; in other words the number of vessels involved, the extent of myocar
dial damage and the degree of electrical instability. Nonmedical aspects
such as the level of education, the degree of social support and the attitude
towards stress also appear to influence the prognosis.
The aim of this volume is to bring together all those factors relevant to
achieving the maximal life span in patients afflicted with a disease that by
its very nature is a lifelong process. However, as the late Paul Dudley White
stated appropriately more than 40 years ago, it is not sufficient merely to
add years to a life, one should also add life to the years. This concept truly is
the nucleus of secondary prevention, sine only a life worth living generates
the motivitation needed to take all the steps necessary in secondary pre
vention.
The authors and the editor are most grateful to Pharma Schwarz Inc. for
their financial support in the publication of this book, as well as to Martinus
Nijhoff Publishers, for its careful and prompt publication.
Hohenried, January 1985 P. Mathes
Contents
Preface ..... .
VlI
List of Contributors
XlI
PART ONE: THE ROLE OF RISK FACTORS
IN SECONDARY PREVENTION
1. Cessation of Smoking
R. Mulcahy 3
2. The Importance of the Cessation of Cigarette Smoking in the
Tertiary Prevention of Coronary Heart Disease
P. Seer, H. Weidemann, Th. Bruhn 11
3. Control of Hypertension
L. Wilhelmsen 17
4. Lipid Lowering Regimens in Secondary Prevention of Coronary
Heart Disease
G. Schlierf 23
PART TWO: THE ROLE OF SOCIAL CLASS
IN SECONDARY PREVENTION
5. Mortality after Myocardial Infarction. Role of Social and
Behavioral Factors
E. Weinblatt, W. Ruberman 33
6. The Impact of Social Level on Prognosis after Myocardial Infarc
tion
H. Gohlke, P. Betz, H. Roskamm 47
7. Social Class and Prognosis in Coronary Heart Disease
N. Hickey 55
x
8. Short and Long-term Prognosis After First Myocardial Infarc
tion. Influences of Social Class
B. Weiss, K. Donat, W,J. Ziegler, K. Ivens, 1. Schuchart 61
PART THREE: The ROLE OF MEDICATION
IN SECONDARY PREVENTION
9. Beta-blocking Agents in Secondary Prevention
A Hjalmarson 69
10. Beta-Blocking Agents in Secondary Prevention After Acute Myo
cardial Infarction with Special Reference to the European Infarct
Study (EIS)
P.R. Lichtlen 81
11. Platelet Aggregation Inhibitors
G.V.R. Born 95
12. Platelet Inhibitors or Anticoagulants for Prevention of Aorto
coronary Bypass Graft Occlusion
M.E. Rothlin 101
13. Cardiovascular Protection by Calcium Antagonists
A Fleckenstein, M. Frey, G. Fleckenstein-Griin. . 109
14. The Influence of Nitrates on Prognosis in Patients with Coronary
Heart Disease
W.D. Bussmann 123
15. Metabolic Aspects of Preventive Drug Administration
H. Kammermeier 133
PART FOUR: THE ROLE OF PHYSICAL EXERCISE
IN SECONDARY PREVENTION
16. The Role of Physical Exercise in Secondary Prevention. Evidence
to Date
G.T. Gau 143
17. The Behavior of the Ejection Fraction at Rest and Exercise in
Myocardial Infarction Before and After a 4-week Training Per
iod. Comparison to a Control Group
E. Grodzinski, G. Bliimchen, 1.S. Borer 151
18. Adaptations to Prolonged Intense Exercise Training in Ischemic
Heart Disease .
AA Ehsani 169
19. Physical Activity and Sudden Death
V. Kallio 177
XI
20. Physical Exercise and Sympathetic Drive
M. Lehmann, J. Keul 187
21. Physical Exercise in Comprehensive Care
J.1. Kellermann 197
22. Exercise Capacity and Regional Myocardial Perfusion Distribu
tion in Ischemic Heart Disease with and without Collateral
Vessels
R. Wolf, P. Pretschner, H. Hundeshagen, P.R. Lichtlen 207
PART FIVE: THE ROLE OF PSYCHOSOCIAL FACTORS
IN SECONDARY PREVENTION
23. Alteration of Type A Behavior and its Effect Upon the Cardiac
Recurrence Rate in Post-myocardial Infarction Patients
c.E.
M. Friedman, J.1. Gill, Thoresen, D. Ulmer 223
24. A 5-year Controlled Clinical Trial on Psychological Well-being
R.AM. Erdman, H.1. Duivenvoorden, M. Kazemier 223
25. Psychosomatic Aspects in Secondary Prevention
R. Hopf, J. Jordan 239
26. Social Isolation and Attitudes Towards Stress. A Behavioral
Trap for Patients After Myocardial Infarction
A Eder, G. Czerwenka-Wenkstetten, M. Niederberger 251
PART SIX: THE ROLE OF REPERFUSION
IN SECONDARY PREVENTION
27. Effect of Percutaneous Transluminal Coronary Angioplasty
G. Kober, C. Vallbracht, R. Hopf, B. Kunkel, M. Kaltenbach 261
28. Single Vessel Stenosis After Acute Myocardial Infarction: Which
Patients Should Undergo Percutaneous Transluminal Coronary
Angioplasty?
N. Danchin, G. Ethevenot, M. Amor, J.P. Godenir, G. Karcher,
M. Cuilliere, D. Amrein, F. Cherrier 269
29. The Role of Coronary Bypass Surgery in Rehabilitation
E. Varnauskas 277
30. Social Fate after Aorto-coronary Bypass Surgery
J. Gehring, W. Koenig, N. Wrana, P. Mathes 283
31. Clinical and Occupational Status of Patients with Coronary
Artery Disease After Surgical Reperfusion
M. Welsch, G. Bergmann, D. Mayer, H.C. Mehmel, W. Saggau,
F. Schwarz, W. Schmitz 293
XII
32. Which Factors do Influence the Rate of Employment After Sur
gical and Medical Treatment in Patients with Coronary Heart
Disease?
1. Jehle, P. Grossmann, L. Kampa, M. Kloke, F. Loogen 305
33. Late Results of Reperfusion with Intracoronary Streptokinase
P.G. Hugenholtz, M.L. Simoons, P.W. Serruys, PJ. de Feyter,
M. van den Brand, P. Fioretti 315
34. Percutaneous Transluminal Coronary Angioplasty After Throm
bolysis to Prevent Reinfarction
1. Meyer, R. Erbel, T. Pop, G. Schreiner, B. Henkel, K. Henrichs,
HJ. Rupprecht, H. Kopp 327
Index ............. ............ . 339
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