Original article Characteristics of patients with coronary artery disease managed on an outpatient basis in the population of Poland. Results of the multicentre RECENT trial

Abstract

Introduction: Comprehension of clinical characteristics and therapeutic methods in patients with coronary artery disease (CAD) is mandatory for the introduction of successful prevention.
Aim: The aim of the multicentre RECENT trial carried out in Poland in 2005 was to gather comprehensive information regarding individuals with CAD treated by specialists as well as by general practitioners on an outpatient basis. In this report, clinical characteristics of the Polish patient population with confirmed CAD are presented.
Methods: A representative group of 215 general practitioners and 67 specialists participated in this study. They collected information about 2593 patients with CAD and filled-in a specially designed questionnaire.
Results: Coronary artery disease was confirmed predominantly based on a history of myocardial infarction (50.1%), followed by positive electrocardiographic stress test (38.8%), history of typical angina in subjects at the age of >60 years (36.4%), history of previous acute coronary syndrome (29.0%), PCI (22.1%) or CABG (14.3%) or positive coronary angiography (17.6%). In patients with diagnosed stable CAD, 44.6% were women and the mean age was 65.0±9.8 years. Among patients with a history of hypertension (78.0%), only 34.0% had blood pressure within the normal range. History of dyslipidaemia was positive in 57.6% of patients. Normal LDL cholesterol concentrations (<3.36 mmol/L) were found in 56.7% of patients. A family history of CAD had 17.3% of subjects, 23.5% had previously detected diabetes mellitus and 11.0% were active smokers at the time of study enrolment. Overweight or obesity both in men and women was found in 79.3% of patients while metabolic syndrome (diagnosed according to NCEP ATP III criteria) was found in 31.3%. The following comorbidities were detected: 34.3% presented symptoms of congestive heart failure, 32.1% had rhythm or conduction disturbances (most commonly atrial fibrillation – in 19.0% of cases). Previous stroke was noted in 4.7% of patients with CAD and transient ischaemic attack in 5.5%. Peripheral artery disease was observed in 9.9% of CAD patients, whereas asthma or COPD – in 9.0%.
Conclusions: The results of the RECENT trial are representative for the CAD patient population managed on an outpatient basis in our country. They suggest that CAD in the Polish population is rather advanced, and indicate still insufficient use of imaging modalities (particularly coronary angiography) and significant prevalence of risk factors throughout this population.