Ischemic Cardiomyopathy Clinic, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
Anesthesiology Department, Hospital General Manuel Gea Gonzalez, Mexico City, Mexico.
High Blood Press Cardiovasc Prev. 2023 Mar;30(2):183-189. doi: 10.1007/s40292-023-00560-x. Epub 2023 Feb 3.
An important challenge in the secondary prevention of cardiovascular diseases is the optimization of risk factors (RFs) after hospital discharge. These have been shown to be insufficiently controlled in clinical practice.
To evaluate whether secondary prevention goals were met at our institution at 12 months after an acute coronary syndrome (ACS) index event, as well as analyzing if achieving these goals was associated with a lower incidence of major adverse cardiovascular events (MACE).
Retrospective cohort of patients with a former diagnosis of ACS over a period of 4 years. To evaluate the proportion of patients who met RF control goals at 12 months after the index event, we used two sets of preestablished goals: stringent and lenient. During follow-up we evaluated the occurrence of MACE, defined by the following: ACS, coronary revascularization, stroke, hospitalization because of acute heart failure and cardiovascular death.
We included 468 patients during the study period. The mean age of the patients was 60 ± 10.76 years, 20.5% were women, and mean follow-up was 41.8 ± 22.0 months. The proportion of patients that met all secondary prevention stringent and lenient goals accounted for 5.5% and 17.2%, respectively, and 8% did not achieve any target. Overall, 9.6% presented the composite of MACE during follow-up. The number of RFs in control at 12 months was associated with a lower rate of MACE, both with stringent and lenient goals.
Achieving established goals for modifiable RFs can lower the incidence of MACE during long-term follow-up.
心血管疾病二级预防的一个重要挑战是优化出院后的危险因素（RFs）。临床实践中这些因素的控制并不充分。
评估在急性冠状动脉综合征（ACS）指数事件后 12 个月，我们机构的二级预防目标是否得到满足，并分析达到这些目标是否与主要不良心血管事件（MACE）发生率降低相关。
对过去 4 年中曾诊断为 ACS 的患者进行回顾性队列研究。为了评估指数事件后 12 个月达到 RF 控制目标的患者比例，我们使用了两套预先设定的目标：严格和宽松。在随访期间，我们评估了 MACE 的发生情况，定义为 ACS、冠状动脉血运重建、中风、因急性心力衰竭住院和心血管死亡。
在研究期间，我们纳入了 468 名患者。患者的平均年龄为 60±10.76 岁，20.5%为女性，平均随访时间为 41.8±22.0 个月。严格和宽松的二级预防目标均达到的患者比例分别为 5.5%和 17.2%，8%的患者未达到任何目标。总体而言，9.6%的患者在随访期间发生了 MACE 复合事件。12 个月时 RF 控制数量与 MACE 发生率降低相关，无论是严格还是宽松的目标。
达到既定的可改变 RFs 目标可以降低长期随访期间 MACE 的发生率。
