open access

Vol 72, No 4 (2014)
Original articles
Published online: 2014-04-09
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Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?

Piotr Jankowski, Danuta Czarnecka, Radosław Łysek, Agnieszka Skrzek, Monika Smaś-Suska, Adam Mazurek, Małgorzata Brzozowska-Kiszka, Renata Wolfshaut-Wolak, Sławomir Surowiec, Piotr Bogacki, Ewa Bryniarska-Mirek, Leszek Bryniarski, Janusz Grodecki, Jadwiga Nessler, Maria Olszowska, Piotr Podolec, Kalina Kawecka-Jaszcz, Andrzej Pająk
DOI: 10.5603/KP.a2013.0350
·
Kardiol Pol 2014;72(4):355-362.

open access

Vol 72, No 4 (2014)
Original articles
Published online: 2014-04-09

Abstract

Background: The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland inrecent years is scarce.

Aim: 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.

Methods: 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.

Results: 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% (p < 0.05), 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%, p < 0.05), 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 p > 0.05).

Conclusions: 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.

Abstract

Background: The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland inrecent years is scarce.

Aim: 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.

Methods: 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.

Results: 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% (p < 0.05), 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%, p < 0.05), 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 p > 0.05).

Conclusions: 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.

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Keywords

coronary artery disease, risk factors, secondary prevention

About this article
Title

Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 72, No 4 (2014)

Pages

355-362

Published online

2014-04-09

DOI

10.5603/KP.a2013.0350

Bibliographic record

Kardiol Pol 2014;72(4):355-362.

Keywords

coronary artery disease
risk factors
secondary prevention

Authors

Piotr Jankowski
Danuta Czarnecka
Radosław Łysek
Agnieszka Skrzek
Monika Smaś-Suska
Adam Mazurek
Małgorzata Brzozowska-Kiszka
Renata Wolfshaut-Wolak
Sławomir Surowiec
Piotr Bogacki
Ewa Bryniarska-Mirek
Leszek Bryniarski
Janusz Grodecki
Jadwiga Nessler
Maria Olszowska
Piotr Podolec
Kalina Kawecka-Jaszcz
Andrzej Pająk

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