ArticleBMC public health2025
Recurrent myocardial infarction and adherence to secondary prevention strategies among adults with coronary artery disease in rural Aluva, South India: a nested case-control study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Themes of Reported Rural Healthcare Challenges Related to Non-Communicable Diseases Before and After the COVID-19 Pandemic: A Scoping Review.International journal of environmental research and public health · 2026Article
- Impact of nursing strategy based on the 6S management model on clinical outcomes in patients with acute myocardial infarction after Percutaneous Coronary intervention.Pakistan journal of medical sciences · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecurrent myocardial infarction (re-MI) remains a significant challenge in cardiovascular care, especially in low-income countries. Despite advancements in cardiac care, many patients with coronary artery disease (CAD) fail to follow the secondary prevention guidelines consistently. This study aims to determine the independent predictors of re-MI and inadequate adherence to secondary prevention strategies among adults with CAD in a rural cohort in South India.
methodsA nested case-control study with risk set sampling of controls was conducted from January 2022 to March 2022 within the ENDIRA (Epidemiology of Non-communicable Diseases In Rural Areas) Cohort in the rural part of Aluva municipality of Ernakulam district, Kerala, India. CAD patients aged 35-80 years from the ENDIRA cohort who have had one or more episodes of myocardial infarction 28 days post the index episode as confirmed by medical reports were selected as cases while those with no recurrent episodes were taken as controls. Descriptive analysis was conducted to characterise the study population and was expressed in frequencies and percentages. Regression models were used to determine the independent predictors of re-MI as well as inadequate adherence and was expressed using adjusted odds ratio along with 95% confidence intervals.
resultsThe study included 187 cases and 436 controls. The independent predictors of recurrent myocardial infarction included poor socio-economic status (Adjusted Odds Ratio [AOR] 1.98; 95% confidence interval [CI] 1.34-2.91), > 5 years since CAD diagnosis (AOR 1.53; 95% CI 1.06-2.22), previous history of CABG (AOR 1.75;95% CI 1.17-2.61), alcohol consumption (AOR 1.65; 95% CI 1.04-2.61), follow up under complementary and alternative medicine (AOR 2.04; 95% CI 1.03-4.01), distance to follow up hospital > 20 kms (AOR 1.85; 95% CI 1.09-3.12) and uncontrolled blood pressure (AOR 1.60; 95% CI 1.07-2.39). The CAD patients preferring private facilities for follow up were 43% less likely to develop recurrent myocardial infarction. (AOR 0.57; 95% CI 0.34-0.95).
conclusionThe determinants of recurrent myocardial infarction and inadequate adherence are multifactorial, encompassing socioeconomic, behavioural and health system factors. Strengthening equitable access to quality secondary prevention services, integrating social support, and improving continuity of cardiac care are essential to reduce recurrence and improve outcomes in rural India.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.