Using a standardized follow-up program to improve coronary heart disease secondary prevention

OBJECTIVE: To reveal the current status and effectiveness of a standardized follow-up of the secondary prevention of coronary heart disease (CHD) at Peking University First Hospital. METHODS: The study group comprised 496 patients diagnosed with CHD between January 1, 2007 and December 31, 2009 after a standardized follow-up program began. A group of 300 patients with CHD diagnosed between January 1, 2004 and December 31, 2004 was evaluated as the control group. The study group participants were followed-up every 3 months for 1 year in the outpatient department and were interviewed by telephone between November 2012 and January 2013. Data on the control of risk-factors, medical therapy, and clinical events were collected. RESULTS: At discharge, 75.4% of the study group patients were non-smokers, 51.4% exercised regularly, 42.4% were overweight, 56.7% had blood pressure <140/90 mm Hg (<130/80 in those with diabetes mellitus), 51% had serum low-density-lipoprotein cholesterol <2.60 mmol/L, and 64.2% had fasting plasma glucose <6.11 mmol/L. Antiplatelet medication was used by 99.4% of the study group patients, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers by 64.5%, beta-blockers by 79.1%, and statins by 94.3%. Major adverse cardiac events, the primary clinical outcome, occurred in 22.7% of the study group patients. The proportions of non-smokers (82.2% vs. 73.7%, p=0.014), control of serum lipids (84.4% vs. 45.6%, p<0.001), and use of statins (92.5% vs. 54.3%, p<0.001) at the end of follow-up were significantly greater in the study group than those in the control group. CONCLUSION: Although some patients with CHD were still not achieving the goals of lifestyle change, control of risk factors, and medication therapy, standardized follow-up helped improve and standardize CHD secondary prevention.