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Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?
- Source :
- Kardiologia Polska. 72:355-362
- Publication Year :
- 2014
- Publisher :
- Polskie Towarzystwo Kardiologiczne, 2014.
-
Abstract
- The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland in recent years is scarce.To compare the implementation of secondary prevention guidelines into everyday clinical practice between 2006-2007 and 2011-2012 in patients after hospitalisation due to CAD.Five hospitals with departments of cardiology serving a city and its surrounding districts in the southern part of Poland participated in the study. Consecutive patients aged ≤ 80 years, hospitalised from April 1, 2005 to July 31, 2006 (first survey) and from April 1, 2010 to June 30, 2011 (second survey) due to acute coronary syndrome or for a myocardial revascularisation procedure were recruited and interviewed 6-18 months after hospitalisation.Medical records of 640 patients were reviewed and included in the first survey and 466 in the second survey. The proportion of medical records with available information on smoking did not differ between the surveys, whereas the proportion of medical records with available information on blood pressure and total cholesterol was lower in patients hospitalised in 2010-2011. The prescription rate of β-blockers at discharge decreased from 90% to 84% (p0.05), whereas the prescription rates at discharge of other drug classes did not change significantly. The proportion of patients with high blood pressure (≥ 140/90 mm Hg) one year after hospitalisation decreased in 2011-2012 compared to 2006-2007 (from 48% to 35%, p0.05), whereas the proportion of subjects with high LDL cholesterol, high fasting glucose, and obesity did not change significantly. We did not note a significant difference in the smoking rate. The proportions of patients taking an antiplatelet agent (90% vs. 91%), a β-blocker (87% vs. 79%), an ACE inhibitor or a sartan (79% vs. 76%), a calcium antagonist (22% vs. 25%), a diuretic (35%vs. 45%), and a lipid-lowering drug (86% vs. 87%) one year after discharge did not change significantly (all p0.05).We noted a modest improvement in the implementation of CAD secondary prevention guidelines in everyday clinical practice: blood pressure was better controlled, although the control of all other main risk factors did not change significantly. Our data provides evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients.
- Subjects :
- Male
Acute coronary syndrome
medicine.medical_specialty
Pediatrics
Adrenergic beta-Antagonists
Myocardial Ischemia
Angiotensin-Converting Enzyme Inhibitors
Coronary Artery Disease
Coronary artery disease
Risk Factors
Secondary Prevention
medicine
Humans
Medical prescription
Aged
Hypolipidemic Agents
Retrospective Studies
Secondary prevention
business.industry
Medical record
Retrospective cohort study
Middle Aged
medicine.disease
Blood pressure
Hypertension
Practice Guidelines as Topic
Emergency medicine
Platelet aggregation inhibitor
Female
Poland
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Forecasting
Subjects
Details
- ISSN :
- 18974279 and 00229032
- Volume :
- 72
- Database :
- OpenAIRE
- Journal :
- Kardiologia Polska
- Accession number :
- edsair.doi.dedup.....75fa08baddbab6862c52802a30aa0ea4