Cor Vasa 2007, 49(9):293-301 | DOI: 10.33678/cor.2007.110

The changing patterns of clinical features and treatment of stable angina in the Czech Republic

Jaromír Hradec¹, Martina Sachová²

¹ III. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy

² Servier, s. r. o., Praha, Česká republika

Aim:
An Angina Treatment Patterns (ATP) survey was performed in 2001 to obtain information about the status of diagnosis and treatment of patients with stable angina in the Czech Republic. A similar survey, ATP III, was conducted in 2006. The results of both surveys were compared.


Groups of patients:
ATP I enrolled 640 patients while ATP III involved 1,308 outpatients with stable angina.

Results:
The following changes were documented over the past 5 years, from 2001 to 2006:
1. Angina patients were on average 2 years older (69 ± 10 vs. 67 ± 9 years).
2. Mean blood pressure levels have increased (139 ± 15/83 ± 9 vs. 136 ± 15/81 ± 8 mmHg) as has the proportion of hypertensive patients (83 vs. 71%).
3. The number of patients with dyslipidemia has increased (78 vs. 66 %) whereas the mean plasma levels of total and LDL-cholesterol have decreased (5.1 ± 1.3 vs. 5.6 ± 0.9 mmol/L
and 3.1 0.9 vs. 3.4 1.0 mmol/L, respectively).
4. The proportion of patients having a myocardial infarction has increased markedly (49.6 vs. 33.0%) as has that of patients having coronary angiography (55.2 vs. 16.3%).
5. Treatment patterns have changed dramatically. The number of invasively treated patients has more than doubled (56.0 vs. 24.4%), mainly because of the increased use of PCI (39.7 vs. 13.3%).
6. Major changes have occurred in drug therapy. The proportion of patients receiving beta-blockers has increased (79.7 vs. 64.4%) while that of patients treated by nitrates has shrunk (65.9 vs. 82.8%). There has been a significant increase in the use of lipid-lowering agents (82.4 vs. 57.0%), with statins playing a clearly dominant role (90.1 vs. 61.9%) and an evident departure from fibrates (9.2 vs. 32.6%). Other drugs used more frequently include ACE inhibitors (60.7 vs. 54.8%) and, more recently, sartans (19.9 vs. 1.3%). The proportion of patients taking oral anticoagulants has increased (12.5 vs. 4.2%) while that of patients using antiplatelet agents has remained almost unaltered (88.6 vs. 87.0%). The spectrum of agents has changed considerably, with a clear tendency towards the use of higher daily doses.

Conclusion:
The risk profile of angina patients in the Czech Republic has deteriorated significantly over the past 5 years. The number of patients treated invasively has doubled and drug therapy has also improved significantly.

Keywords: Stable angina; Drug therapy; ATP survey; Secondary prevention of CHD

Published: September 1, 2007  Show citation