{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:23:37Z","timestamp":1791890617956,"version":"4.3.4"},"reference-count":21,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Advances in the acute treatment of myocardial infarction (AMI) substantially reduced in-hospital mortality, but the post-discharge prognosis is still unacceptable. The Managed Care in Acute Myocardial Infarction (MC-AMI) is a program of Poland\u2019s National Health Fund that aims at comprehensive post-AMI care to improve long-term prognosis. The aim of the study was to assess the effect of MC-AMI on all-cause mortality in one-year follow-up. Methods: MC-AMI includes acute MI treatment, complex revascularization, cardiac rehabilitation (CR), scheduled one-year outpatient follow-up, and prevention of sudden cardiac death. In this retrospective observational study performed in a province of Silesia, Poland, we analyzed 3893 MC-AMI participants, and compared them to 6946 patients in the control group. After propensity score matching, we compared two groups of 3551 subjects each. To assess the effect of MC-AMI and other variables on mortality, we preformed a Cox regression. Results: MC-AMI was related with mortality reduction by 38% in a 12-month observation period and the effect persisted even after. Multivariable Cox regression analysis revealed MC-AMI participation to be inversely associated with 1-year mortality (HR 0.52, 95%CI 0.42\u20130.65, p &lt; 0.001). Besides that, older age (HR 1.47\/10 y), ST-elevation AMI (HR 1.41), heart failure (HR 2.08), diabetes (HR 1.52), and dialysis (HR 2.38) were significantly associated with the primary endpoint. Among MC-AMI components, cardiac rehabilitation (HR 0.34) and strict outpatient care (HR 0.42) are the crucial factors affecting mortality reduction. Conclusions: Participation in MC-AMI reduced 1-year mortality by 38% and the effect persisted after the program had been completed.<\/jats:p>","DOI":"10.3390\/jcm9103178","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T09:41:01Z","timestamp":1601458861000},"page":"3178","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Managed Care after Acute Myocardial Infarction (MC-AMI) Reduces Total Mortality in 12-Month Follow-Up\u2014Results from a Poland\u2019s National Health Fund Program of Comprehensive Post-MI Care\u2014A Population-Wide Analysis"],"prefix":"10.3390","volume":"9","author":[{"given":"Krystian","family":"Wita","sequence":"first","affiliation":[{"name":"First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3140-1806","authenticated-orcid":false,"given":"Andrzej","family":"Ku\u0142ach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Ziolowa 47, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Sikora","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Fluder","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-513X","authenticated-orcid":false,"given":"Ewa","family":"Nowalany-Kozielska","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Milewski","sequence":"additional","affiliation":[{"name":"American Heart of Poland, 43-100 Tychy, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"P\u0105czek","sequence":"additional","affiliation":[{"name":"Voivodeship Specialist Hospital no 5, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henryk","family":"Sobocik","sequence":"additional","affiliation":[{"name":"Voivodeship Specialist Hospital no 2, 44-330 Jastrzebie Zdroj, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Olender","sequence":"additional","affiliation":[{"name":"Scanmed, 30-693 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucjan","family":"Szela","sequence":"additional","affiliation":[{"name":"Scanmed, 30-693 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Kalarus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Buszman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6223-8821","authenticated-orcid":false,"given":"Piotr","family":"Jankowski","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariusz","family":"G\u0105sior","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland"},{"name":"3rd Department of Cardiology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e356","DOI":"10.1136\/bmj.e356","article-title":"25 years trends in first hospitalization for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: A Danish nationwide cohort study","volume":"344","author":"Schmidt","year":"2012","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1161\/CIRCOUTCOMES.111.964700","article-title":"Long-term survival and recurrence after acute myocardial infarction in England, 2004 to 2010","volume":"5","author":"Smolina","year":"2012","journal-title":"Circ. 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