The quality of secondary prevention of coronary heart disease in Czech patients in the EUROASPIRE III survey

Abstract

Introduction: The main objectives of prevention are to reduce morbidity and mortality, and to improve quality of life. Aim: To determine, in patients with coronary heart disease, whether the treatment goals, as defined by current guidelines on secondary prevention, are implemented in clinical practice. Methods: A total of 600 consecutive patients, men and women aged≤80 years, were identified retrospectively with the following diagnoses: coronary artery bypass grafting, percutaneous transluminal coronary angioplasty or acute coronary syndrome. Data collection was based on a review of medical records and interview at least six months after hospital admission. Results: In total, 493 responders were interviewed. Among them, 21% were smokers, 37.3% were obese, 54% had raised blood pressure (≥140/90 mmHg or 135/80 mmHg in those with diabetes), 56.8% had elevated LDL-cholesterol (≥2.5 mmol/l) and 42% had overt diabetes (glucose > 7 mmol/l or antidiabetic treatment).At interview, 88% of patients were treated with beta-blockers, 60.2% with ACE inhibitors, 81.9% with statins and 92.7% with aspirin or anticoagulants. Only a minority of patients followed the non-pharmacologic recommendations. Conclusion: In spite of marked improvement in pharmacotherapy, there is a considerable potential to raise the standard of preventive cardiology through optimal control of risk factors to defined targets and, moreover, through improvement in non-pharmacologic interventions of life-style factors.