1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
Pol Arch Intern Med. 2021 Aug 30;131(7-8):673-678. doi: 10.20452/pamw.16001. Epub 2021 May 18.
Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events, and risk factor control is crucial in this population.
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.
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.
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.
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.
患有冠状动脉疾病（CAD）的患者有发生心血管事件复发的高风险，在这类人群中，控制风险因素至关重要。
本研究旨在比较 2011 年至 2013 年和 2016 年至 2017 年欧洲心脏病学会指南在预防 CAD 复发方面的实施情况。
该研究纳入了 5 家具有心脏病科的医院，为克拉科夫市及其周边地区服务。连续入选的已确诊 CAD 患者在 2011 年至 2013 年和 2016 年至 2017 年住院后 6 至 18 个月接受了访谈。
我们共检查了 2011 年至 2013 年的 616 例患者和 2016 年至 2017 年的 388 例患者（平均[标准差]年龄，64.7[8.8]岁 vs 66.4[8.4]岁；P<0.01）。调整协变量后，2016 年至 2017 年与 2011 年至 2013 年相比，高血压患者比例下降了 8.9%（95%置信区间，-15.6%至-2.1%），低密度脂蛋白胆固醇水平高的患者比例下降了 9.5%（95%置信区间，-16.7%至-2.2%），而吸烟患者比例（-0.2%[95%置信区间，-6%至 5.5%]）和血糖水平高（3.9%[95%置信区间，-2.2%至 10%]）和体重指数为 25 kg/m2 或更高（3.8%[95%置信区间，-3.9%至 11.6%]）的患者比例没有变化。在第二阶段，更多的患者被开具了抗血小板药物、β受体阻滞剂、血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂、钙拮抗剂和抗凝剂。
我们观察到 CAD 患者服用心血管药物的比例增加，因此血压和低密度脂蛋白胆固醇的控制略有改善。其他主要危险因素没有变化。
