Please select the eligibility criteria that correspond to the clinical trial below.
Title: COR-PRIM: Problem-based Learning in Patient Education After an Event of Coronary Heart Disease. A Randomised Study in Primary Care of Long-term Effects on Self-care
Brief Summary: The hypothesis is that problem based learning (PBL) in patient education positively affects self-care agency of lifestyle changes after an event of coronary heart disease (CHD). The investigators therefore aim to determine whether long-term follow-up in primary health care in patient education involving PBL affects self-care behaviour in terms of patients' beliefs, self-efficacy and empowerment to make lifestyle changes. The general aim is to evaluate if PBL in patient education after CHD affects long-term self-care in relation to present lifestyle goals. Another aim of the study is to perform an economic assessment of long term effects of life style changes reached by using PBL after en event of CHD.


Options:
A: Inclusion Criteria:

* Patients of all ages with CHD verified by MI and/or Percutaneous Coronary Intervention (PCI) and/or coronary artery by-pass surgery (CABG) within 12 months before planned start of the intervention.
* Patients should be stable regarding their cardiac conditions and have optimised cardiac medication not substantially changed during the last month, completed heart school in hospital care (if applicable), listed at one of five specific primary health care centres agreed to join the project at time of inclusion.

Exclusion Criteria:

* Planned CABG or other causes demanding continued cardiologist care; e.g. on-going contact with heart failure clinic due to drug titration or investigations e.g. myocardial scintigraphy to detect ischemia before a new PCI
* Life expectancy ≤ 1 year, documented psychiatric disease that render difficulties to cooperate with other people or obvious abuse of alcohol or narcotics.
* Patients will also be excluded if they are unable to communicate or read the Swedish language and if they participate in other studies affecting the results.
B: Inclusion Criteria:

* Patients aged 60 years and older, undergoing elective isolated coronary artery bypass grafting (CABG), aortic valve repair/replacement for moderate aortic stenosis or severe regurgitation, mitral valve repair/replacement for moderate stenosis or severe regurgitation or combined CABG/valve procedures
* Patients with Clinical Frailty Score (CFS) ≥3 (vulnerable) and \< 7 (8 = very severely frail, approaching end-of-life or 9 = terminally ill) at time of acceptance for cardiac surgery
* Patients with an estimated ≥ 6 week wait time

Exclusion Criteria:

* Patients who have unstable or recent unstable cardiac syndrome as defined by:

  1. Severe heart failure (NYHA IV) or angina (CCS class IV) symptoms
  2. Critical left main (LM) coronary disease
  3. Hospitalization for arrhythmias, congestive heart failure or acute coronary syndrome prior to randomization
* Patients who have severe left ventricular obstructive disease as defined by:

  1. Severe aortic or mitral stenosis (aortic or mitral valve area \<1.0cm2 or mean gradient \> 40 mmHg or \> 10 mmHg respectively)
  2. Dynamic left ventricular (LV) outflow obstruction
* Patients who have demonstrated exercise induced ventricular arrhythmias or have experienced a recent hospitalization for arrhythmias
* Patients who have cognitive deficits that would preclude rehabilitation
* Patients who have physical limitations that would preclude rehabilitation
* Patients who are unable to attend the Prehab program
C: Inclusion Criteria:

* Two months to 10 years from the cardiovascular event.
* Left ventricular ejection fraction \> 30%
* Ability to undertake regular physical activity (walking and biking)

Exclusion Criteria:

* Moderate to severe heart valvular disease.
* Atrial fibrilation.
* Uncontrolled atrial or ventricular arrhythmias.
* Exercise induced myocardial ischaemia.
* Pericardial disease.
* Uncontrolled hypertension.
* Insulin dependent diabetes mellitus.
* Moderate to severe chronic lung disease (Vital capacity and/or forced expiratory volume during the first second \<80% to that expected for the age).
* Severe kidney disease (renal creatinine clearance \<30 mL/min, calculated by Cockcroft-Gault formula).
* Anaemia (haemoglobin \<12 g/dL).
* Life expectancy less than one year.
D: Inclusion Criteria:

* coronary heart disease patients

Exclusion Criteria:

* unstable angina pectoris
* hemodynamic significant valve disease (\> New York Heart Association class II)
* pregnancy
* left ventricular ejection fraction \<30%
* kidney failure (creatinin \> 140)
* uncontrolled hypertension

Answer: A