Search Results (412)

Background: The aim of this study was to explore the baseline characteristics, risk factors, and prognosis of surgical patients with left-sided valvular infective endocarditis (IE) complicated by preoperative neurological complications, as well as the impact of complication subtypes and surgical timing on outcomes. Methods: A retrospective analysis of 605 consecutive surgical patients with left-sided valvular IE (May 2012–June 2024) was performed. Patients were stratified into neurological complication and non-complication groups, with 1:1 propensity score matching (PSM) balancing baseline confounders. Six neurological complication subtypes were defined; surgical timing was categorized as early (≤7 days for infarction, ≤30 days for hemorrhage) or delayed. Logistic/Cox regression analyzed risk factors and prognosis; subgroup analyses compared modified Rankin Scale (mRS) scores, and Kaplan–Meier curves evaluated long-term survival. Results: Mitral valve involvement, highly mobile vegetations, and longer IE symptom-to-surgery time were risk factors for neurological complications. After PSM balancing, the neurological complications group had similar in-hospital, long-term mortality to the control group, but a significantly higher new-onset cerebral complication rate. In total, 81.5% of complication patients achieving mRS ≤ 2 (good functional status) with infarction showed improved postoperative mRS scores. Cerebral hemorrhage was an independent predictor of in-hospital mortality, while cerebral hemorrhage and regional infarction were independent predictors of new-onset cerebral complication. Early surgery in infarction patients increased the neurological complication rate. Conclusion: Neurological complication incidence was 27.8%. Mitral valve involvement, high vegetation mobility, and preoperative emboli were risk factors. Except for preoperative cerebral hemorrhage and regional infarction, which increase the risk of in-hospital mortality, neurological complications overall do not affect short-term and long-term mortality rates, but increase the risk of postoperative neurological deterioration. Individualized surgical timing is recommended. Full article

Background: Papillary thyroid carcinoma in the isthmus (PTCI) remains a subject of surgical debate due to its unique anatomical location and reportedly more aggressive behavior, including higher rates of lymph node metastasis, multifocality, extrathyroidal extension, and capsular invasion. There are currently no definitive guidelines regarding the optimal extent of surgery. Objective: This study aimed to compare the three surgical approaches—total thyroidectomy, lobectomy with isthmusectomy, and isthmusectomy/extended isthmusectomy—in patients with PTCI, focusing on postoperative complications, tumor recurrence, recovery, and identifying risk factors for tumor prognosis and lymph node metastasis. Methods: We retrospectively analyzed data from 215 patients treated surgically across four medical centers from 2016 to 2022, divided into three groups based on surgical extent. We compared baseline characteristics, operative time, intraoperative blood loss, length of hospital stay, postoperative complications, and central lymph node metastasis risk factors. Propensity Score Matching (PSM) was used to create more comparable groups, so as to verify the accuracy and stability of our research results. Results: No significant differences were observed among the three groups in rates of temporary or permanent recurrent laryngeal nerve injury, permanent hypoparathyroidism, or chyle leakage (all p > 0.05). However, transient hypoparathyroidism was more common in the total thyroidectomy group (p < 0.05), which also had longer operative time, greater intraoperative blood loss, and longer postoperative hospital stay (all p < 0.05) The PSM-adjusted analyses further confirmed these findings, except that the previously observed difference in postoperative drainage volume among the three groups was no longer significant (p = 0.791). The Kaplan–Meier curves showed a similar cumulative proportion of recurrence-free survivors in the three groups with no statistically significant difference observed (p = 0.804). Univariate and multivariate logistic regression analysis identified that gender (OR = 4.405, 95%CI: 4.104–4.729, p < 0.001), multifocality (OR = 2.498, 95%CI: 1.064–5.864, p = 0.035), tumor diameter (OR = 1.096, 95%CI: 1.047–1.147, p < 0.001), capsular invasion (OR = 2.666, 95%CI: 2.547–2.791, p < 0.001), and absolute eosinophil count (OR = 1.381, 95%CI: 1.125–1.695, p = 0.002) remained significant independent predictors of central lymph node metastasis in PTCI. A multivariable logistic regression model was developed to predict CLNM, achieving an AUC of 0.777. A probability threshold of 0.50 provided the best balance between sensitivity (77.6%) and specificity (65.5%) and was selected as the clinical cut-off for stratifying high- and low-risk patients. Conclusions: Conservative procedures like lobectomy with isthmusectomy or isthmusectomy/extended isthmusectomy may represent a feasible, function-preserving option in carefully selected low-risk PTCI patients, but further validation is required. In contrast, patients with high-risk features may benefit from central lymph node dissection. The predictive model may provide supportive information for personalized surgical planning. Full article

Background/Objectives: Lactoferrin, a key bioactive component in human milk, may bridge functional gaps in infant formula; however, its long-term effects on growth and the gut microbiota in term infants remain underexplored, particularly in real-world settings. Methods: This real-world evidence (RWE) study assessed the impact of lactoferrin-fortified formula (LF) on infant growth, the gut microbiota, and feeding tolerance compared with control formula (CF) and exclusive breastfeeding (BF). After propensity score matching (PSM) for maternal education level and infant age, 111 matched Chinese infants (37 per group: LF, CF, and BF; age: 6–12 months) were analyzed. Growth was evaluated using WHO Z-scores (WAZ, LAZ, WLZ, and zBMI). The gut microbiota was profiled via 16S rRNA sequencing (n = 81). Feeding challenges were quantified using the Montreal Children’s Hospital Feeding Scale (MCH-FS). Results: The LF group exhibited significantly higher length-for-age Z-scores (LAZ) compared with both the BF and CF groups (p < 0.001), indicating superior linear growth. LF infants also showed reduced MCH-FS scores (18.0 vs. 36.2 in CF; p < 0.001), signifying fewer feeding difficulties. Gut microbiota analysis revealed enrichment of Bifidobacterium breve and butyrate-producing taxa (e.g., Faecalibacterium and Ruminococcaceae), higher alpha diversity, and metabolic divergence, involving enhanced lysine fermentation to acetate/butyrate in LF infants, suggesting a higher level of short-chain fatty acid (SCFA) production. Beta diversity analysis demonstrated that the LF microbiota clustered close to BF. Conclusions: Lactoferrin-fortified formula was associated with improved linear growth and feeding tolerance while shaping a healthy gut microbiota, showing similarities to breastfed infants’ microbiota. These findings support LF fortification as a strategy to improve functional outcomes in formula-fed infants. Full article

Objectives: To evaluate the prognosis and costs of gemcitabine + cisplatin + S-1 (GCS) versus gemcitabine + cisplatin + durvalumab (GCD), the standard of care for advanced cholangiocarcinoma, in a prospective observational study. Methods: We enrolled 52 patients who received GCS as first-line treatment from April 2020 to April 2024 and 44 patients who received GCD from March 2023 to April 2024. Overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) were examined. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups, and OS, PFS and ORR were then analysed in the matched cohorts. Drug costs were compared until the end of treatment. Results: OS was not significantly different between GCS and GCD at 18.6 months (95% confidence interval [CI]: 13.3–21.9) (p = 0.0935) versus 12.2 months (95% CI: 7.5–16). PFS was 10.2 months (95% CI: 6.5–13.8) versus 6.2 months (95% CI: 3.2–8.8) for GCS versus GCD, respectively (p = 0.0151). The ORR was also higher for GCS (36.5%) than for GCD (15.9%) (p = 0.0234). Twenty-seven patients were included in the PSM analysis, which showed no significant differences in OS or ORR, and better PFS for GCS (9.3 months, 95% CI: 7.4–21.1 versus 4.8 months, 95% CI: 2.7–8.8; p = 0.007). The cost of GCS versus GCD was $6350 (95% CI: 2300–9800) versus $97,200 (95% CI: 69,400–138,800) by treatment end (p = 0.0001). Conclusions: GCS was significantly less expensive than GCD and showed comparable OS and better PFS. Full article

Background: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with a high mortality rate. Early identification of patients at risk for in-hospital CS is crucial for timely intervention. This study aimed to develop a risk prediction model for CS using admission data. Methods: This retrospective case–control study included AMI patients and classified them into case and control groups, based on the development of in-hospital CS. Clinical information at admission was obtained and 1:1 propensity score matching (PSM) was performed based on age, gender, and diagnosis of ST-elevation myocardial infarction. Factors with p < 0.10 at baseline were incorporated to identify the independent risk factors, which were further used to construct a predictive nomogram. Results: After PSM, 374 patients were finally enrolled in both groups. After relaxed least absolute shrinkage and selection operator and multivariate logistic regression, independent risk factors identified for CS in AMI patients included systolic blood pressure [odds ratio (OR): 0.866; 95% confidence interval (CI): 0.844–0.888, p < 0.001], diastolic blood pressure (OR: 1.031; 95% CI: 1.001–1.063, p = 0.046), triglycerides (OR: 0.561; 95% CI: 0.385–0.820, p = 0.003), creatinine (OR: 1.005; 95% CI: 1.000–1.010, p = 0.048), globulin (OR: 0.915; 95% CI: 0.862–0.972, p = 0.004), left ventricular ejection fraction (OR: 0.951; 95% CI: 0.928–0.975, p < 0.001), and coronary angiography (OR: 0.183; 95% CI: 0.058–0574, p = 0.004). The nomogram incorporating these variables demonstrated an area under the curve of 0.937 (95% CI: 0.952–0.967), indicating good discriminatory ability in the calibration curve and decision curve. Conclusions: Seven independent risk factors for CS in AMI patients were identified upon admission. The proposed nomogram might facilitate early risk stratification and guide clinical decision-making to improve outcomes. Full article

Background/Objectives: Minimally invasive thoracic surgery has evolved rapidly, with uniportal video-assisted thoracoscopic surgery (U-VATS) and robotic-assisted thoracic surgery (RATS). Biportal-RATS (Bi-RATS) has emerged as a hybrid technique, combining robotics advantages with the reduced invasiveness of U-VATS. The aim of this study was to evaluate the safety, perioperative outcomes, lymphadenectomy, and postoperative quality of life (QoL) of Bi-RATS compared with U-VATS for lung resections. Methods: This single-center, observational cohort study included 130 consecutive patients undergoing anatomical lung resection between December 2021 and December 2024. Baseline and perioperative characteristics, including complications, chest drain duration, hospital stay, and lymph node yield, were analyzed. Health-related QoL was assessed preoperatively and 6 months postoperatively using the EQ-5D-5L questionnaire and EQ-VAS. Propensity score matching (PSM) at a 1:1 ratio was performed to minimize selection bias, obtaining 32 patients per group. Results: After PSM, the baseline characteristics were comparable between groups. Operative time was longer with Bi-RATS (221.3 ± 84.5 vs. 119.3 ± 53.4 min, p < 0.001). No significant differences were observed in postoperative complications, drain duration, or hospital stay. Bi-RATS seemed to be associated with a higher lymph node yield, particularly in segmentectomies. At 6 months, the overall EQ-VAS was comparable between techniques (78.9 U-VATS vs. 78.1 Bi-RATS; p = 0.832), while among the EQ-5D-5L dimensions, only mobility favored Bi-RATS (p = 0.045). Conclusions: Bi-RATS appears safe and effective, with perioperative outcomes and overall EQ-VAS comparable to those of U-VATS 6 months after surgery. These findings suggest that Bi-RATS may represent a valuable evolution of minimally invasive thoracic surgery. Full article

Background: Left atrial appendage (LAA) closure is an alternative to oral anticoagulants (OAC) for stroke prevention in atrial fibrillation (AF), but comparative evidence remains inconsistent. This study systematically evaluates the efficacy and safety of LAA closure versus OAC in AF patients. Methods: We systematically searched PubMed, EmBase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) and propensity score-matched (PSM) studies published up to 30 September 2025. Treatment effects were estimated using relative risks (RR) with 95% confidence intervals (CI), and a random-effects model was applied for all analyses. Results: Fifteen studies (17,116 AF patients) were included, comprising 4 RCTs, 3 prospective PSM studies, and 8 retrospective PSM studies. Compared with OAC, LAA closure significantly reduced the composite endpoint (RR: 0.79; 95% CI: 0.66–0.95; p = 0.010), all-cause mortality (RR: 0.58; 95% CI: 0.49–0.69; p < 0.001), and cardiovascular mortality (RR: 0.55; 95% CI: 0.44–0.67; p < 0.001). Risks of any stroke (RR: 1.06; 95% CI: 0.86–1.31; p = 0.555), ischemic stroke (RR: 1.00; 95% CI: 0.85–1.17; p = 0.972), hemorrhagic stroke (RR: 0.96; 95% CI: 0.54–1.70; p = 0.879), and major bleeding (RR: 0.84; 95% CI: 0.67–1.04; p = 0.112) were not significantly different between groups. Conclusions: In AF patients, LAA closure significantly reduces mortality and a composite clinical endpoint compared to OAC, with similar risks of stroke and major bleeding. It is a favorable alternative for patients unsuitable for long-term anticoagulation. Full article

Background: This study aimed to assess whether methylprednisolone treatment, while effective in reducing COVID-19 mortality, increases the risk of intensive-care-unit-acquired respiratory tract infections (RTI-ICU) in critically ill patients. Methods: This was a multicenter prospective cohort study conducted in ten countries across Latin America and Europe. It included patients over 18 years of age with confirmed SARS-CoV-2 infection who required ICU admission. A multivariable logistic regression analysis and propensity score matching (PSM) were performed to determine the association between methylprednisolone treatment and RTI-ICU. Results: A total of 3239 patients were included, of whom 1527 patients (47.1%) were treated with methylprednisolone. Methylprednisolone treatment was associated with a higher risk of developing RTI-ICU (OR = 1.59; 95% CI: 1.33–1.91). Patients with RTI-ICU had a significantly higher average number of days on invasive mechanical ventilation (IMV) (24.6, SD: 15.9 vs. 9.5, SD: 11.7; p < 0.001), longer hospital stays (40 days, SD: 24.9 vs. 24.4 days, SD: 18.7; p < 0.001), and higher ICU mortality (39.2%, 259/660 vs. 29.2%, 754/2579; p < 0.001). Conclusions: Methylprednisolone treatment is associated with an increased risk of RTI-ICU in critically ill patients with COVID-19. RTI-ICU was linked to higher mortality, a greater need for invasive mechanical ventilation, prolonged ICU stay, elevated leukocyte and C-reactive protein levels, and a higher comorbidity burden. However, methylprednisolone may not be the sole factor explaining these differences, as residual confounding related to baseline disease severity and comorbidities could have influenced the outcomes. Full article

Background/Objectives: Diabetes mellitus (DM), especially insulin-dependent DM (IDDM), is strongly associated with adverse outcomes following percutaneous coronary intervention (PCI) failure. Polymer-free drug-eluting stents (PF-DESs) have emerged as a promising strategy to mitigate long-term coronary inflammation. This study aimed to evaluate the role of PF-DES, as compared to permanent-polymer DES (PP-DES) and biodegradable-polymer DES (BP-DES), in a real-world cohort of IDDM patients with obstructive coronary artery disease (CAD) undergoing PCI. Methods: IDDM patients with CAD who underwent PCI with DES at Parma University Hospital were divided into two study groups: PF-DES group vs. BP/PP-DES group. The primary endpoint was target vessel failure (TVF) at the 4-year follow-up. Survival analyses and propensity score matching (PSM) were performed to account for baseline differences. Results: A total of 170 IDDM patients with 215 treated lesions (31.6% PF-DES; 68.4% BP/PP-DES) were included. The PF-DES group experienced significantly lower rates of TVF (10.3% vs. 27.2%, p < 0.01, log rank p = 0.0072) compared with the BP/PP-DES group. PSM analysis confirmed the good clinical performance of PF-DES (HR 0.27, p < 0.01). Conclusions: In this PSM-based observational study, PF-DESs were associated with significantly lower rates of TVF compared with BP/PP-DESs in IDDM patients undergoing PCI for CAD. These suggest that PF-DES may represent a personalized PCI strategy for IDDM patients, with prognostic benefits that become increasingly pronounced as the clinical and anatomical risk profile worsens. Full article

Compared with single indicators such as total factor productivity and financial performance, enterprise competitiveness represents the pivotal factor for energy storage enterprises (ESEs) to survive, develop and maintain a leading position in the market. Government subsidies are crucial for guiding the development of the energy storage industry. As countries globally increase their financial backing for ESEs, efficiently utilizing these subsidies has become a major focus. In this study, we examine the impact and mechanisms of government subsidies on the competitiveness of ESEs, using panel data from 248 listed ESEs in China between 2014 and 2023. Employing a range of analytical methods, including two-way fixed effects regression, instrumental variable estimation, and propensity score matching (PSM) tests, the findings demonstrate that government subsidies significantly enhance the competitiveness of ESEs, particularly for non-state-owned ESEs, energy storage system integration enterprises, and ESEs in resource-rich provinces. Further analysis indicates that research and development (R&D) expenditure and financial constraints act as key channels through which subsidies influence competitiveness. Furthermore, electricity prices exert a positive effect on the competitiveness of ESEs, with government subsidies and electricity prices exhibiting a significant substitution relationship in this regard. These findings offer valuable insights for exploring the role of government subsidies in advancing the sustainable development of the energy storage industry and supporting the transition towards achieving dual-carbon goals, while also providing important references for the development of the energy storage industry in other emerging economies. Full article

Background and Objectives: Obstructive sleep apnea (OSA) is a clinically relevant comorbidity in both alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). However, whether its impact differs between these etiologies remains unclear. This study directly compared OSA risk in patients with AFLD and NAFLD to elucidate its role in disease progression. Materials and Methods: We conducted a retrospective cohort study using the TriNetX research network. Adults aged ≥ 20 years with newly diagnosed AFLD or NAFLD between 2006 and 2020 were included. Propensity score matching was applied to balance demographic and clinical covariates. The primary endpoint was incident OSA, assessed at 1-, 2-, 3-, and 5-year intervals, and cumulatively through 28 September 2025. Effect estimates were expressed as relative risk, odds ratio and hazard ratio (HR). Results: Before matching, 896,302 NAFLD and 12,694 AFLD patients were identified; after 1:1 PSM, 11,583 patients remained in each group with balanced baseline characteristics. NAFLD patients consistently demonstrated higher OSA risk. Post-matching, OSA incidence became significantly elevated from year 2 onward (HR at 2 years = 1.764) and persisted at 3 years (HR = 2.078), 5 years (HR = 1.950), and cumulative follow-up (HR = 1.940). Conclusions: NAFLD confers nearly double the long-term OSA risk compared with AFLD. These findings support longitudinal OSA screening and targeted risk reduction strategies in NAFLD populations. Full article

Background and purpose: Stent-assisted coiling (SAC) achieves immediate aneurysm occlusion, while flow diversion (FD) promotes progressive remodeling. Comparative data in unruptured anterior circulation aneurysms remain limited. Methods: A retrospective review of our institutional database was conducted between 2021 and 2024. A total of 129 aneurysms treated with SAC (n = 33) or FD (n = 96) were identified and included in the analysis. Outcomes included angiographic occlusion, retreatment, complications, and the modified Rankin Scale (mRS). A 1:1 propensity score matching (PSM) was performed on sex, age, aneurysm size, and location (caliper 0.2, exact sex matching). Results: A total of 130 patients (89 women, 41 men) were included in the study, with a mean age of 59.8 years (range 22–81). In the full cohort, SAC achieved higher immediate complete occlusion (62.5% vs. 8.3%, p < 0.001), while FD demonstrated superior long-term stability (71.9% vs. 60.6%). Retreatment occurred in 18.2% of SAC cases and none with FD (p < 0.001). Complication rates were comparable overall: intraoperative (15.2% SAC vs. 10.4% FD, p = 0.37), periprocedural ≤72 h (15.2% vs. 8.3%, p = 0.34), and delayed ≥12 months (9.1% vs. 10.4%, p = 0.85). In patients aged 70–80 years, periprocedural complications were more frequent with SAC (37.5% vs. 5.9%, p = 0.08). Functional independence (mRS 0–2) at last follow-up was 87.9% for SAC and 89.6% for FD (p = ns). In the matched cohort, SAC preserved higher immediate occlusion (60% vs. 10%, p < 0.001), whereas FD provided greater long-term occlusion (65% vs. 55%, p = 0.33) and required no retreatments versus 15% in SAC (p < 0.001). Subgroup analysis showed that SAC-related complications were largely confined to complex Y/T-stent reconstructions for MCA bifurcation and AComA aneurysms, while single-stent SAC demonstrated a safety profile comparable to FD. Conclusions: SAC offers rapid angiographic exclusion but at the cost of higher retreatment. FD ensures durable occlusion and absence of retreatment, with a consistent safety profile. After stratification by technical complexity, excess morbidity associated with SAC originated from anatomically demanding multistent constructs, whereas single-stent SAC showed safety comparable to FD. Age may influence periprocedural risk, particularly with SAC. These findings reinforce a tailored strategy: “Close fast with SAC, close forever with FD.” Full article

Background: Despite the increasing adoption of minimally invasive direct coronary artery bypass (MIDCAB), data on its long-term outcomes—particularly regarding sex-based differences—remain limited. This study presents a robust 20-year analysis comparing males and females, assessing perioperative outcomes, long-term survival, and independent predictors of mortality to inform sex-sensitive clinical decision-making. Methods: A retrospective cohort analysis of 676 patients (138 females, 538 males) undergoing MIDCAB was performed. Propensity score matching (PSM) generated balanced female and male cohorts (n = 129 each). Preoperative demographics, short-term outcomes, and long-term survival were assessed using Kaplan–Meier analysis and Cox regression modelling. Results: In unmatched cohorts, females exhibited significantly lower NYHA class distribution (p = 0.011) and higher atrial fibrillation prevalence (p = 0.038), with otherwise comparable comorbidities. Propensity score matching achieved cohort balance, and short-term outcomes—including 30-day mortality, stroke/TIA, and reoperation—were similar across sexes. Kaplan–Meier analysis of matched cohorts revealed no significant survival difference (log-rank p = 0.3370), though females demonstrated greater 20-year survival than males (77.6% versus 55.8%). In females, age 70–79 (HR 2.66; 95% CI: 1.02–6.95; p = 0.046) and cerebrovascular disease (HR 5.33; 95% CI: 1.49–19.03; p = 0.010) were independently associated with mortality. In males, significant predictors included diabetes (HR 1.86; 95% CI: 1.02–3.38; p = 0.042), chronic kidney disease (HR 4.92; 95% CI: 1.21–20.02; p = 0.026), pulmonary disease (HR 2.35; 95% CI: 1.20–4.60; p = 0.013), cerebrovascular disease (HR 4.77; 95% CI: 1.97–11.56; p < 0.001), and reduced left ventricular ejection fraction (HR 0.17; 95% CI: 0.06–0.43; p < 0.001). Conclusions: This 20-year study, the longest to date, demonstrates that MIDCAB achieves durable and equivalent long-term survival in males and females. It highlights sex-specific predictors of mortality, emphasizing the necessity for personalized preoperative risk assessment and postoperative management. Full article

Enterprises fulfilling ESG responsibilities represent a strategic choice to achieve sustainable and high-quality development. Using the sample of A-share state-owned listed companies in China from 2015 to 2022, this study investigates the association of mixed ownership reform (MOR) of state-owned enterprises (SOEs) with ESG rating divergence. The findings reveal that MOR significantly exacerbates ESG rating divergence, particularly in firms with lower equity concentration, smaller scale, those in heavily polluting industries, and those with higher ESG disclosure levels. Robustness checks, including utilizing alternative measurement approaches, lagging sample periods, the propensity score matching (PSM) method, and the difference-in-differences (DID) model, address potential endogeneity issues and confirm the validity of these results. Further analysis demonstrates that MOR increases ESG rating divergence by reducing information transparency and cutting human capital investment, while enhancing ESG disclosure quality mitigates this divergence. These insights advance understanding of the tensions between governance reforms and sustainability metrics in transitional economies, providing a perspective for sustainable corporate governance of enterprises in the background of policy reform. Full article

Background/Objectives: Cardiac rehabilitation (CR) is the most important element in the process of returning patients to everyday functioning. The aim of the study was to compare the frequency of use of various forms of CR in terms of the occurrence of various risk factors in patients after acute coronary syndrome (ACS). Methods: The study was conducted in a group of 1600 patients after ACS across 4 time points: 3, 6, 12 months, and 5 years. Patients were classified into four groups: (1) patients who do not participate in any rehabilitation programme after hospital treatment (0 + 0); (2) patients participating in a sanatorium programme (0 + S); (3) patients participating in an outpatient programme (0 + A); (4) patients participating in both forms (A + S). The study retrospectively analysed patients’ medical records for the following risk factors: smoking, hypertension, and obesity. The relationship between the four groups and the likelihood of undergoing a given form of rehabilitation was determined (Odds ratio [OR]; 95% confidence interval [CI]). Group matching in terms of gender and age was also applied using Propensity Score Matching (PSM). Results: Among those who did not undergo rehabilitation (0 + 0) 6 months after ACS, compared to the baseline groups, the most common were those who returned to smoking (OR = 3.42) and those with persistent obesity (OR = 3.69); after 5 years–individuals who reduced their obesity (OR = 4.86; after PSM: OR = 6.51). The highest chance of A + S rehabilitation was observed in the 3rd and 6th month in the group of people who quit smoking (OR = 7.60; OR = 6.04), after 6 months in the ‘reduction in uncontrolled hypertension’ group (OR = 11.44) and after 3 months in the ‘Reduction in obesity (after PSM)’ group (OR = 7.80). Conclusions: The most effective reduction in selected risk factors is reached by participation in sanatorium and ambulatory programmes (A + S). Full article