Long-term secondary prevention of acute myocardial infarction (SEPAT) – guidelines adherence and outcome

BMC Cardiovascular Disorders

Research Article

Erik Thunström¹  Annika Rosengren¹  Constantinos Ergatoudes¹  Michael Fu²  Lena Björck³  Kristin Falk⁴  Kristina Bengtsson Boström⁵ 

[1] Department of Molecular and Clinical Medicine, Institute of Medicine, Skövde, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Skövde, Sweden;Department of Medicine, Section of Cardiology, Sahlgrenska University Hospital/Östra, 41651, Göteborg, Sweden;Department of Molecular and Clinical Medicine, Institute of Medicine, Skövde, Sweden;Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Skövde, Sweden;Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Skövde, Sweden;R & D Centre Skaraborg Primary Care, Skövde, Sweden;

关键词: Secondary prevention;    Cardiovascular disease;    Myocardial infarction;    Long-term;   

DOI  :  10.1186/s12872-016-0400-6

 received in 2016-06-16, accepted in 2016-11-07,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundA number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI.MethodsPatients aged 18–85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden. All patients who agreed to participate in the study (16.2%) were invited for a structured interview, physical examinations and laboratory analysis 2 years after AMI. Guideline-directed secondary preventive goals were defined as optimally controlled blood pressure, serum cholesterol, glucose, regular physical activity, smoking cessation and pharmacological treatment.ResultsThe mean age of the study cohort (n = 200) at the index AMI was 63.0 ± 9.7 years, 79% were men. Only 3.5% of the cohort achieved all six guideline-directed secondary preventive goals 2 years after infarction. LDL < 1.8 mmol/L was achieved in 18.5% of the cohort, regular exercise in 45.5% and systolic blood pressure <140 mmHg in 57.0%. Anti-platelet therapy was used by 97% of the patients, beta-blockers by 83.0%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers by 76.5% and statins by 88.5%. During follow-up, non-fatal adverse cardiovascular events (cardiac hospitalization, recurrent acute coronary syndrome, angina pectoris, new percutaneous coronary intervention, new onset of atrial fibrillation, post-infarct heart failure, pacemaker implantation, stroke/transient ischemic attack (TIA), cardiac surgery and cardiac arrest) occurred in 47% of the cohort and readmission due to cardiac causes in 30%.ConclusionsOur data showed the failure of secondary prevention in our daily clinical practice and high rate of non-fatal adverse cardiovascular events 2 years after AMI.

【 授权许可】

CC BY   
© The Author(s). 2016