eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
5/2018
vol. 14
 
Share:
Share:
more
 
 
abstract:
Clinical research

Practice setting and secondary prevention of coronary artery disease

Piotr Jankowski, Danuta Czarnecka, Leszek Badacz, Piotr Bogacki, Jacek S. Dubiel, Janusz Grodecki, Tomasz Grodzicki, Janusz Maciejewicz, Ewa Mirek-Bryniarska, Jadwiga Nessler, Wiesław Piotrowski, Piotr Podolec, Wanda Śmielak-Korombel, Wiesława Tracz, Kalina Kawecka-Jaszcz, Andrzej Pająk

Arch Med Sci 2018; 14, 5: 979–987
Online publish date: 2017/01/19
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Patients with established coronary artery disease (CAD) are at high risk of recurrent cardiovascular events. The aim of the analysis was to compare time trends in the extent to which cardiovascular prevention guidelines have been implemented by primary care physicians and specialists.

Material and methods
Five hospitals with cardiology departments serving the city and surrounding districts in the southern part of Poland participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after hospitalization. The surveys were carried out in 1997–1998, 1999–2000, 2006–2007 and 2011–2013.

Results
The proportion of smokers increased from 16.0% in 1997–1998 to 16.4% in 2011–2013 among those who declared that a cardiologist in a hospital outpatient clinic decided about the treatment, from 17.5% to 34.0% (p < 0.01) among those treated by a primary care physician, and from 7.0% to 19.7% (p = 0.06) among patients treated in private cardiology practices. The corresponding proportions were 44.6% and 42.4% (p < 0.01), 47.7% and 52.8% (p = 0.53), 44.2% and 42.2% (p = 0.75) for high blood pressure, and 42.5% and 71.2% (p < 0.001), 51.4% and 79.6% (p < 0.001), 52.4% and 72.4% (p < 0.01) for LDL cholesterol level not at recommended goal. The proportion of patients prescribed cardioprotective medications increased in every analyzed group.

Conclusions
The control of cardiovascular risk in CAD patients has only slightly improved since 1997/98 in all health care settings. The greatest potential for further improvement was found among patients whose post-hospital care is provided by primary care physicians. It is associated with promotion of a no-smoking policy and enhanced prescription of guideline-recommended drugs.

keywords:

coronary artery disease, secondary prevention, cardiovascular risk, smoking, cholesterol, blood pressure

references:
De Bacquer D, Dallongeville J, Kotseva K, et al. Residual risk of cardiovascular mortality in patients with coronary heart disease: the EUROASPIRE Risk Categories. Int J Cardiol 2013; 168: 910-4.
Simpson CR, Buckley BS, McLernon DJ, et al. Five-year prognosis in an incident cohort of people presenting with acute myocardial infarction. PLoS One 2011; 6: e26573.
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2012; 33: 1635-701.
Kawecka-Jaszcz K, Jankowski P, Pająk A, et al. Cracovian program for secondary prevention of ischaemic heart disease. Part III. Secondary prevention of ischaemic heart disease after discharge. Przegl Lek 2001; 58: 964-8.
Jankowski P, Kawecka-Jaszcz K, Pajak A, et al. Cracovian program for secondary prevention of ischemic heart disease. Secondary prevention of ischemic heart disease after discharge in 1997-98 and 1999-2000. Przegl Lek 2003; 60: 142-6.
Pajak A, Jankowski P, Kawecka-Jaszcz K, et al. Changes in secondary prevention of coronary artery disease in the post-discharge period over the decade 1997-2007. Comparison of Cracovian Program for Secondary Prevention of Ischaemic Heart Disease and Polish parts of EUROASPIRE II and EUROASPIRE III surveys. Kardiol Pol 2009; 67: 1353-9.
Jankowski P, Czarnecka D, Łysek R, et al. Secondary prevention in patients after hospitalization due to coronary artery disease – what has changed since 2006? Kardiol Pol 2014; 72: 355-62.
Jankowski P, Czarnecka D, Wolfshaut-Wolak R, et al. Secondary prevention of coronary artery disease in contemporary clinical practice. Cardiol J 2015; 22: 219-26.
Euroaspire II Study Group. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries. Principal results from EUROASPIRE II. Euro Heart Survey Programme. Eur Heart J 2001; 22: 554-72.
Kotseva K, Wood D, De Backer GD, et al. (The EUROASPIRE Study Group). EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009; 16: 121-37.
Kotseva K, Wood D, De Bacquer D, et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol 2016; 23: 636-48.
Cybulska B, Ceremużyński L, Hanzlik J, et al. Hyperlipidemia. Kardiol Pol 1997; 46 (Suppl. I): 119-32.
Prevention of coronary heart disease in clinical practice. Recommendations of the Second Joint Task Force of European and other Societies on coronary prevention. Eur Heart J 1998; 19: 1434-503.
De Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: third joint task force of European and other societies on cardiovascular disease prevention in clinical practice. Eur J Cardiovasc Prev Rehabil 2003; 10: S1-10.
Reiner Z, Catapano AL, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011; 32: 1769-818.
Chlebus K, Gąsior M, Gierlotka M, et al. Epidemiology, treatment and secondary prevention of myocardial infarctions in Poland. http://www.rehabilitacjakardiologicznaptk.pl/zawaly-serca-w-polsce-raport/ (access: 11.01.2017).
Palazón-Bru A, Gil-Guillén VF, Orozco-Beltrán D, et al. Is the physician’s behavior in dyslipidemia diagnosis in accordance with guidelines? Cross-sectional ESCARVAL study. PLoS One 2014; 9: e91567.
Banach M, Rizzo M, Toth PP, et al. Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel. Arch Med Sci 2015; 11: 1-23.
Aronow WS. Lipid-lowering therapy in older persons. Arch Med Sci 2015; 11: 43-56.
Broncel M, Gorzelak-Pabiś P, Sahebkar A, et al. Sleep changes following statin therapy: a systematic review and meta-analysis of randomized placebo-controlled polysomnographic trials. Arch Med Sci 2015; 11: 915-26.
Poloński L, Gasior M, Gierlotka M, et al. Polish Registry of Acute. Coronary Syndromes (PL-ACS). Characteristics, treatments and outcomes of patients with acute coronary syndromes in Poland. Kardiol Pol 2007; 65: 861-72.
Grajek S, Lesiak M, Araszkiewicz A, et al. Short- and long-term mortality in patients with ST-elevation myocardial infarction treated with different therapeutic strategies. Results from WIelkopolska REgional 2002 Registry (WIRE Registry). Kardiol Pol 2008; 66: 154-63.
Banasiak W, Wilkins A, Pociupany R, et al. Pharmacotherapy in patients with stable coronary artery disease treated on an outpatient basis in Poland. Results of the multicentre RECENT study. Kardiol Pol 2008; 66: 642-9.
Sliż D, Mamcarz A, Filipiak KJ, et al. 3ST-POL trial: standards of statin use in Poland in the context of the European Society of Cardiology guidelines. Pol Arch Med Wewn 2010; 120: 328-33.
Opolski G, Strojek K, Kurzelewski M, et al. Cardiovascular therapy, diagnostic procedures, and control of risk factors in patients with diabetes or coronary artery disease in Poland: the Kardia-Pol registry. Pol Arch Med Wewn 2012; 122: 413-21.
Budnik M, Opolski G. The assessment of coronary heart disease risk factors correlated with demographic and social data in post-coronary intervention patients in Polish population. Cardiol J 2015; 22: 276-84.
Szychta W, Majstrak F, Opolski G, et al. Trends in pharmacological therapy of patients referred for coronary artery bypass grafting between 2004 and 2008: a single-centre study. Kardiol Pol 2015; 73: 1317-26.
Yusuf S, Islam S, Chow CK, et al. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet 2011; 378: 1231-43.
Murphy E, Vellinga A, Byrne M, et al. Primary care organisational interventions for secondary prevention of ischaemic heart disease: a systematic review and meta-analysis. Br J Gen Pract 2015; 65: e460-8.
Dudek D, Siudak Z, Solheim S. New model of secondary cardiovascular prevention for patients after acute coronary syndromes in Poland with regard to Norwegian experiences. Kardiol Pol 2016; 74: 101-3.
Jankowski P, Niewada M, Bochenek A, et al. Optimal model of comprehensive rehabilitation and secondary prevention. Kardiol Pol 2013; 71: 995-1003.
FEATURED PRODUCTS
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe