de Velasco José A, Cosín Juan, de Oya Manuel, de Teresa Eduardo
Servicio de Cardiología, Hospital General Universitario, Valencia, España.
Rev Esp Cardiol. 2004 Feb;57(2):146-54.
Secondary prevention measures for myocardial infarction are inadequate. In Spain, the earlier PREVESE studies provided preliminary data. The aim of this study was to document the results of a simple intervention program for secondary prevention, implemented during the hospital stay.
We included 4174 patients (mean age 63.7 years, 73% men) discharged from 110 hospitals after myocardial infarction. Lipid profile was determined during the first 24 h after admission, and before discharge patients and relatives were informed about the disease and its prevention, and were given printed informative materials. The patients were seen again 6 months later.
After 6 months, 82.9% of the patients were examined and 10% were lost to follow-up. Mean blood pressure, weight and body mass index of the sample were lower, and lifestyle variables had improved. At discharge 87% were prescribed statins, 59.4% beta blockers, 51.2% ACE inhibitors and angiotensin blockers, and 94.1% antiplatelet drugs. These prescriptions were still being used 6 months later. There were substantial improvements in lipid values.
The implementation of a simple intervention program for patients with myocardial infarction and their relatives, and the determination of lipid levels within 24 hours of admission, improved the secondary prevention measures at discharge and during the 6-month follow-up period. Acceptance of the program among the patients was good.
心肌梗死的二级预防措施并不充分。在西班牙，早期的PREVESE研究提供了初步数据。本研究的目的是记录在住院期间实施的一项简单二级预防干预计划的结果。
我们纳入了110家医院中4174例心肌梗死后出院的患者（平均年龄63.7岁，73%为男性）。入院后最初24小时内测定血脂水平，出院前向患者及其亲属告知疾病及其预防知识，并给予印刷的宣传资料。6个月后对患者进行再次访视。
6个月后，82.9%的患者接受了检查，10%失访。样本的平均血压、体重和体重指数较低，生活方式变量有所改善。出院时，87%的患者服用他汀类药物，59.4%服用β受体阻滞剂，51.2%服用ACE抑制剂和血管紧张素阻滞剂，94.1%服用抗血小板药物。6个月后这些处方仍在使用。血脂值有显著改善。
对心肌梗死患者及其亲属实施简单的干预计划，并在入院24小时内测定血脂水平，改善了出院时及6个月随访期内的二级预防措施。患者对该计划的接受度良好。
