Vol 27, No 5 (2020)
Original articles — Clinical cardiology
Published online: 2020-05-20

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Secondary prevention of coronary artery disease in Poland. Results from the POLASPIRE survey

Piotr Jankowski1, Dariusz A. Kosior23, Paweł Sowa4, Karolina Szóstak-Janiak5, Paweł Kozieł1, Agnieszka Krzykwa3, Emilia Sawicka4, Maciej Haberka6, Małgorzata Setny3, Karol Kamiński4, Zbigniew Gąsior6, Aldona Kubica7, Dirk De Bacquer8, Guy De Backer8, Kornelia Kotseva9, David Wood9, Andrzej Pająk10, Danuta Czarnecka1
Pubmed: 32436589
Cardiol J 2020;27(5):533-540.


Background: The highest priority in preventive cardiology is given to patients with established coronary artery disease (CAD). The aim of the study was to assess the current implementation of the guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates in patients following hospitalization for CAD.

Methods: Fourteen departments of cardiology participated in the study. Patients (aged ≤ 80 years) hospitalized due an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after the hospitalization.

Overall, 947 patients were examined 6–18 months after hospitalization. The proportion of patients
with high blood pressure (≥ 140/90 mmHg) was 42%, with high low-density lipoprotein cholesterol (LDL-C ≥ 1.8 mmol/L) 62%, and with high fasting glucose (≥ 7.0 mmol/L) 22%, 17% of participants were smokers and 42% were obese. The proportion of patients taking an antiplatelet agent 6–18 months after hospitalization was 93%, beta-blocker 89%, angiotensin converting enzyme inhibitor or sartan 86%, and a lipid-lowering drug 90%. Only 2.3% patients had controlled all the five main risk factors well (non-smoking, blood pressure < 140/90 mmHg, LDL-C < 1.8 mmol/L and glucose < 7.0 mmol/L, body mass index < 25 kg/m2), while 17.9% had 1 out of 5, 40.9% had 2 out of 5, and 29% had 3 out of 5 risk factors uncontrolled.

The documented multicenter survey provides evidence that there is considerable potential for further reductions of cardiovascular risk in CAD patients in Poland. A revision of the state funded cardiac prevention programs seems rational.

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