Cor Vasa 2019, 61(3):e277-e283 | DOI: 10.33678/cor.2019.007

Current status of secondary prevention in Czech coronary patients in the EUROASPIRE V Study

Jan Bruthans^a,b, Otto Mayer jr.^b, Pavel Šulc^a, Kristina Hašplová^a, Martina Cvíčela^b, Július Gelžinský^b, Markéta Hronová^b, Jan Filipovský^b, Renata Cífková^a

^a Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague

^b Center of Preventive Cardiology, 2nd Department of Medicine, Faculty of Medicine, Pilsen, Charles University Prague and University Hospital in Pilsen, Pilsen

Introduction: Secondary prevention after myocardial infarction is at least as important as treatment of the acute phase. Improved cardiovascular (CV) prevention can decisively contribute to the continuation of positive trends of CV morbidity and mortality seen in the Czech Republic in last three decades.

Objectives: To determine, in patients with coronary heart disease (CHD), how the treatment goals as defined by the current European guidelines on CV secondary prevention (2012) are implemented in clinical practice.

Methods: Patients ≤ 80 years when hospitalized for acute coronary syndrome, and/or CABG or PCI were identified from hospital records and invited to outpatient clinical investigation (interview) not less than 6 months and not more than 2 years after hospital discharge. Data collection was performed based on a review of medical records and the interview.

Results: Of 624 invited patients, 406 responders were interviewed. Among these, 20% were smokers, 44.8% were obese (BMI ≥ 30), 85.5% were overweight or obese (BMI ≥ 25), 70.2% had central obesity (waist circumference ≥ 102 cm in men, ≥ 88 cm in women), the recommended level of physical activity (30 minutes 5 times a week) was not attained by 85%. Raised blood pressure (≥ 140/90 mmHg, in diabetics ≥ 140/80 mmHg) was measured in 55.1%, elevated LDL-cholesterol (≥ 1.8 mmol/L) in 63.5% of responders. Manifest diabetes mellitus (known plus newly discovered at interview) was present in 41.2%, and prediabetes in 23.4% of patients. The respective figures when using the oral glucose tolerance test (OGTT) were 44.7% and 32.3%. At interview, 88.4% of patients were being treated with aspirin or other antiplatelet drugs, 81.3% with beta-blockers, 78.8% with ACE inhibitors or angiotensin receptor blockers (ARBs), 92.1% with statins, and 92.9% had undergone revascularization., Conclusion: The majority of coronary patients have unhealthy lifestyles such as unhealthy diet and sedentary behavior. The prevalence of overweight, obesity, and diabetes is very high, and prevalence of obesity further increased. Although pharmacotherapy is used in the majority of patients, the recommended levels of blood pressure, lipid, and glucose metabolism are achieved in only a minority.

Keywords: Cardiovascular risk factors, Coronary heart disease, EUROASPIRE-V, Guidelines, Secondary prevention

Received: February 5, 2019; Accepted: March 5, 2019; Published: June 21, 2019  Show citation