[Secondary prevention of ischemic heart disease after coronary revascularization].

This study was aimed to assess the compliance with policies for secondary prevention of coronary heart disease (CHD) one year after coronary artery revascularization with special attention to the management of hyperlipidemia. One year after coronary revascularization during the year 1994, patients were contacted by letter to determine the modification of their risk factors, the treatment patterns for hypercholesterolemia and to have their plasma lipid level and blood pressure measured. Of the 245 consecutive patients contacted (110 after coronary artery bypass grafting, and 135 after percutaneous transluminal coronary angioplasty), 186 (76%) provided the information required for further analysis. Excluding the patients older than 65 years, only 29 out of 97 patients (30%) with a total cholesterol of more than 5.2 mmol/l, and only 20 out of 52 patients (38%) with a total cholesterol of more than 6.2 mmol/l were receiving lipid lowering therapy 1 year after coronary artery revascularization. In contrast, 97% (n = 180) of the entire population studied were taking antiplatelet drugs and/or coumadine. Participation in an in-house rehabilitation program yielded a positive influence on smoking, but not on treatment of hypercholesterolemia. In conclusion, only a small proportion of patients with documented CHD and hypercholesterolemia were being treated for their lipid disorder 1 year after coronary artery revascularization. In contrast, the great majority of patients received antiplatelet and/or coumadine therapy: These results indicate that the compliance with published treatment guidelines for hyperlipidemia in patients with CHD is still highly inadequate, irrespective of the participation in a rehabilitation program.