Cor Vasa 2014, 56(2):e91-e97 | DOI: 10.1016/j.crvasa.2014.01.008

The changes in cardiovascular prevention practice between 1995 and 2012 in the Czech Republic. A comparison of EUROASPIRE I, II, III and IV study

Otto Mayer jr.^a,b,*, Jan Bruthans^a,b, Katarína Timoracká^a,b

^a II. interní klinika a Biomedicínské centrum (UniMeC), Lékařská fakulta Plzeň, Univerzita Karlova v Praze a Fakultní nemocnice Plzeň, Plzeň, Česká republika

^b Centrum kardiovaskulární prevence, 1. lékařská fakulta Univerzity Karlovy a Thomayerova nemocnice, Praha, Česká republika

Definite evidence has been established, that coronary patients benefit from appropriate secondary prevention. A series of EUROASPIRE surveys evaluated the level of implementation of coronary heart disease (CHD) prevention Guidelines. We aimed to evaluate the changes in adherence to treatment targets during 16 years and to compare the mortality in Czech patients with manifest CHD.
Four independent descriptive surveys were undertaken in 1995/1996, 1999/2000, 2006/2007 and 2012/2013. Consecutive patients less than 71 years of age suffering for acute coronary event and/or revascularization procedure were identified and examined at least 6 months afterwards.
The study population included 4 series of 331, 410, 421 and 372 patients.
The prescription of basic pharmacotherapy markedly improved, namely use of statins increased more than 12 times (from 7.3 to 93.3%). Proportion of patients who underwent revascularization increased from 49% to 95%. Prevalence of hypercholesterolemia and raised blood pressure significantly decreased from 87% to 39% and from 64% to 40%, respectively 10-year all-cause mortality rates decreased significantly between 1995 and 1999 from 28 to 18%. On the other hand, proportion on smoking did not change significantly, while prevalence of overt diabetes increased more than twice. In conclusion, in spite of the fact that the compliance with the recommendations for secondary prevention markedly improved in single factors, global achievement of desired target remained rather unsatisfactory, likewise in other European countries.

Keywords: Coronary heart disease; EUROASPIRE; Guidelines; Mortality; Secondary prevention

Received: November 6, 2013; Revised: January 21, 2014; Accepted: January 28, 2014; Published: April 1, 2014  Show citation