Implementation of cardiovascular prevention guidelines in clinical practice. Results from the POLASPIRE II survey

There is limited knowledge about the implementation of current guidelines in every-day clinical practice.

To describe risk factors management in patients with coronary artery disease through lifestyle modifications and the use of drug therapies to provide an objective assessment of the implementation of the current guidelines on cardiovascular prevention.

Twelve departments of cardiology in 6 regions participated in the study (conducted in 2022-2023). Patients (aged ≤80 years) were recruited and interviewed 6-18 months following hospitalization due to an acute coronary syndrome (68.7%) or a myocardial revascularization procedure (31.3%).

A total of 801 patients (median age 66.4 years, 595 men and 206 women) were examined. The proportion of patients with high blood pressure was 66.5%, with high low-density lipoprotein cholesterol 79.8%, and with high HbA1c 16.0%; 19.5% of participants were active smokers, and 80.5% were overweight/obese. The proportion of patients taking at least one antiplatelet/antithrombotic agent was 92.8%, a β-blocker 84.7%, an angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor blocker 79.8%, and a lipid-lowering drug 89.5% patients. Only 8.6% patients had all the 5 main risk factors well controlled, while 2.4% had all risk factors at recommended target and were prescribed an antiplatelet or an antithrombotic drug and an angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor blocker.

There is considerable opportunity of further reduction of cardiovascular risk in Polish patients treated for coronary artery disease. A revision of the ongoing and more intensive endorsement of cardiovascular prevention programs is advisable.