Unfavourable risk factor control after coronary events in routine clinical practice

Area of Science:

• Cardiology
• Public Health
• Preventive Medicine

Background:

• Inadequate risk factor control post-coronary event noted in prior European studies.
• Potential underestimation of poor control in routine practice due to patient selection and low participation.
• Need for better understanding of patient factors influencing risk factor control for improved secondary prevention.

Purpose of the Study:

• Determine risk factor control in a routine clinical practice coronary population.
• Investigate the influence of age, gender, number of coronary events, and time since event on risk factor control.

Main Methods:

• Cross-sectional study of 1127 patients (83% participation) with acute myocardial infarction and/or revascularization.
• Data collected via questionnaires, clinical exams, and blood samples at 2-36 months post-event.
• Analysis of risk factor control (smoking, obesity, hypertension, LDL cholesterol, diabetes) and associations with patient factors.

Main Results:

• 21% current smokers; 56% of index event smokers continued.
• 34% obese, 60% physically inactive.
• 46% hypertensive, 57% elevated LDL cholesterol (>1.8 mmol/L), 59% suboptimal diabetes control.
• Patients averaged control of only 3/6 major risk factors.
• Poorest control in patients with >1 coronary event (p<0.001).
• Increased smoking and obesity observed with longer time since event (p<0.01, p<0.05).

Conclusions:

• Majority of coronary patients in this Norwegian population did not achieve adequate risk factor control.
• Patients with multiple coronary events exhibited the poorest risk factor management.
• Urgent need for novel secondary prevention strategies to enhance risk factor control and improve patient health outcomes.