First Department of Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527, Athens, Greece.
Department of Cardiology, Laiko General Hospital, 11527 Athens, Greece.
J Prev Med Hyg. 2022 Dec 31;63(4):E598-E603. doi: 10.15167/2421-4248/jpmh2022.63.4.2684. eCollection 2022 Dec.
Optimal regulation of modifiable risk factors has been proposed as the standard of care both for primary and secondary prevention of cardiovascular disease (CVD). The aim of this study was to assess primary and secondary cardiovascular risk management received before admission for an acute coronary event.
Data were analyzed for 185 consecutive hospitalized patients with a diagnosis of acute coronary syndrome (ACS) in the Cardiology department of a University hospital during an annual period (1/7/2019 until 30/6/2020). The study population was divided into two groups, the primary and secondary prevention subgroups, according to previous medical history of cardiovascular disease (CVD).
The mean age of the participants was 65.5 ±12.2 years and most patients were male (81.6%). Previous CVD was present in 51 patients (27.9%). Fifty-seven patients (30.8%) had a history of diabetes mellitus (DM) and 97 (52.4%) had a history of dyslipidemia. Hypertension was present in 101 (54.6%) patients. In the secondary prevention group, the LDL-C was on target in only 33.3% of the patients, while 20% patients did not use statins. The use of antiplatelet/anticoagulant agents was 94.5%. Among patients with diabetes, only 20% had been using a GLP-1 receptor agonist or/and an SGLT-2 inhibitor, while the HbA was on target in 47.8%. Twenty-five percent of the patients were active smokers. In the primary prevention group, the use of statins was overall low (25.8%) but more frequent in patients with diabetes and those without diabetes at very high-risk for CVD (47.1% and 32.1% respectively). The LDL-C was on target in less than 23.1% of the patients. The use of antiplatelet/anticoagulant agents was low (20.1%), but higher in those with diabetes (52.9%). In the diabetic group, HbA was on target in 61.8%. Active smoking was practiced by 46.3% of the patients.
Our data show that in a substantial proportion of patients presenting with ACS, previous CVD prevention, both primary and secondary, fails to meet the current recommendations provided by scientific societies.
优化可调节风险因素的管理，这被提议作为心血管疾病（CVD）一级和二级预防的标准。本研究旨在评估急性冠状动脉事件入院前接受的一级和二级心血管风险管理。
对一家大学医院心内科在一个年度期间（2019 年 7 月 1 日至 2020 年 6 月 30 日）收治的 185 例急性冠状动脉综合征（ACS）住院患者的数据进行了分析。根据患者先前的心血管疾病（CVD）病史，将研究人群分为一级和二级预防亚组。
参与者的平均年龄为 65.5 ±12.2 岁，大多数患者为男性（81.6%）。51 例（27.9%）患者有既往 CVD 病史。57 例（30.8%）有糖尿病（DM）病史，97 例（52.4%）有血脂异常病史。101 例（54.6%）患者患有高血压。在二级预防组中，只有 33.3%的患者 LDL-C 达标，而 20%的患者未使用他汀类药物。抗血小板/抗凝药物的使用率为 94.5%。在患有糖尿病的患者中，只有 20%使用了 GLP-1 受体激动剂和/或 SGLT-2 抑制剂，而 HbA 达标率为 47.8%。25%的患者是活跃吸烟者。在一级预防组中，他汀类药物的总体使用率较低（25.8%），但在糖尿病患者和 CVD 极高风险但无糖尿病患者中更为常见（分别为 47.1%和 32.1%）。不到 23.1%的患者 LDL-C 达标。抗血小板/抗凝药物的使用率较低（20.1%），但在糖尿病患者中较高（52.9%）。在糖尿病组中，HbA 达标率为 61.8%。46.3%的患者吸烟。
我们的数据表明，在相当一部分患有 ACS 的患者中，一级和二级预防的既往 CVD 预防均未达到科学协会提供的现行建议。
