Changes over time in the prevention of recurrent coronary artery disease in everyday practice
Jan W Pęksa1, Piotr Jankowski2, Paweł Kozieł1
11st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
Insights
This study found improved blood pressure and cholesterol control in coronary artery disease (CAD) patients due to better cardiovascular drug prescription. However, other risk factors like smoking and obesity remain unchanged.
Area of Science:
- Cardiology
- Public Health
- Clinical Research
Background:
- Patients with coronary artery disease (CAD) face a high risk of recurrent cardiovascular events.
- Effective risk factor control is paramount for managing CAD patients and preventing future events.
Purpose of the Study:
- To compare the implementation of European Society of Cardiology guidelines for preventing recurrent CAD.
- To assess changes in risk factor management between 2011-2013 and 2016-2017.
Main Methods:
- The study involved 5 hospitals in the Kraków region.
- Consecutive patients with established CAD were interviewed 6-18 months post-hospitalization in two distinct periods: 2011-2013 and 2016-2017.
Main Results:
- A decrease in high blood pressure (8.9%) and high low-density lipoprotein cholesterol (9.5%) was observed in the later period.
- Prescription rates for antiplatelets, beta-blockers, ACE inhibitors/ARBs, calcium antagonists, and anticoagulants increased.
- No significant changes were noted in smoking rates, high glucose levels, or obesity (BMI ≥ 25 kg/m²).
Conclusions:
- An increase in cardiovascular drug prescriptions led to slight improvements in blood pressure and LDL cholesterol control.
- Despite improved medication adherence, other key risk factors for coronary artery disease require further attention.
Introduction:
Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events, and risk factor control is crucial in this population.
Objectives:
The aim of the study was to compare the implementation of the European Society of Cardiology guidelines regarding prevention of recurrent CAD in 2011 to 2013 with 2016 to 2017.
Patients And Methods:
The study included 5 hospitals with cardiology departments serving the city of Kraków and its surrounding districts. Consecutive patients with established CAD were interviewed 6 to 18 months after hospitalization in the years 2011 to 2013 and 2016 to 2017.
Results:
We examined 616 patients in 2011 to 2013 and 388 in 2016 to 2017 (mean [SD] age, 64.7 [8.8] years vs 66.4 [8.4] years; P <0.01). After adjusting for covariates, the proportion of patients with high blood pressure decreased by 8.9% (95% CI, -15.6% to -2.1%) and the proportion of patients with high level of low‑ density lipoprotein cholesterol declined by 9.5% (95% CI, -16.7% to -2.2%) in 2016 to 2017 compared with 2011 to 2013, whereas the proportion of smoking patients (-0.2% [95% CI, -6% to 5.5%]) and those with high glucose levels (3.9% [95% CI, -2.2% to 10%]) and a body mass index of 25 kg/m2 or greater (3.8% [95% CI, -3.9% to 11.6%]) did not change. More patients were prescribed antiplatelets, β‑ blockers, angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, calcium antagonists, and anticoagulants in the second period.
Conclusions:
We observed an increase in the proportion of patients with CAD who were prescribed cardiovascular drugs, and consequently a slight improvement in the control of their blood pressure and low‑ density lipoprotein cholesterol. No changes were found regarding other main risk factors.
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