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Practice setting and secondary prevention of coronary artery disease
INTRODUCTION: Patients with established coronary artery disease (CAD) are at high risk of recurrent cardiovascular events. The aim of the analysis was to compare time trends in the extent to which cardiovascular prevention guidelines have been implemented by primary care physicians and specialists....
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111342/ https://www.ncbi.nlm.nih.gov/pubmed/30154878 http://dx.doi.org/10.5114/aoms.2017.65236 |
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author | Jankowski, Piotr Czarnecka, Danuta Badacz, Leszek Bogacki, Piotr Dubiel, Jacek S. Grodecki, Janusz Grodzicki, Tomasz Maciejewicz, Janusz Mirek-Bryniarska, Ewa Nessler, Jadwiga Piotrowski, Wiesław Podolec, Piotr Śmielak-Korombel, Wanda Tracz, Wiesława Kawecka-Jaszcz, Kalina Pająk, Andrzej |
author_facet | Jankowski, Piotr Czarnecka, Danuta Badacz, Leszek Bogacki, Piotr Dubiel, Jacek S. Grodecki, Janusz Grodzicki, Tomasz Maciejewicz, Janusz Mirek-Bryniarska, Ewa Nessler, Jadwiga Piotrowski, Wiesław Podolec, Piotr Śmielak-Korombel, Wanda Tracz, Wiesława Kawecka-Jaszcz, Kalina Pająk, Andrzej |
author_sort | Jankowski, Piotr |
collection | PubMed |
description | INTRODUCTION: Patients with established coronary artery disease (CAD) are at high risk of recurrent cardiovascular events. The aim of the analysis was to compare time trends in the extent to which cardiovascular prevention guidelines have been implemented by primary care physicians and specialists. MATERIAL AND METHODS: Five hospitals with cardiology departments serving the city and surrounding districts in the southern part of Poland participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after hospitalization. The surveys were carried out in 1997–1998, 1999–2000, 2006–2007 and 2011–2013. RESULTS: The proportion of smokers increased from 16.0% in 1997–1998 to 16.4% in 2011–2013 among those who declared that a cardiologist in a hospital outpatient clinic decided about the treatment, from 17.5% to 34.0% (p < 0.01) among those treated by a primary care physician, and from 7.0% to 19.7% (p = 0.06) among patients treated in private cardiology practices. The corresponding proportions were 44.6% and 42.4% (p < 0.01), 47.7% and 52.8% (p = 0.53), 44.2% and 42.2% (p = 0.75) for high blood pressure, and 42.5% and 71.2% (p < 0.001), 51.4% and 79.6% (p < 0.001), 52.4% and 72.4% (p < 0.01) for LDL cholesterol level not at recommended goal. The proportion of patients prescribed cardioprotective medications increased in every analyzed group. CONCLUSIONS: The control of cardiovascular risk in CAD patients has only slightly improved since 1997/98 in all health care settings. The greatest potential for further improvement was found among patients whose post-hospital care is provided by primary care physicians. It is associated with promotion of a no-smoking policy and enhanced prescription of guideline-recommended drugs. |
format | Online Article Text |
id | pubmed-6111342 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-61113422018-08-28 Practice setting and secondary prevention of coronary artery disease Jankowski, Piotr Czarnecka, Danuta Badacz, Leszek Bogacki, Piotr Dubiel, Jacek S. Grodecki, Janusz Grodzicki, Tomasz Maciejewicz, Janusz Mirek-Bryniarska, Ewa Nessler, Jadwiga Piotrowski, Wiesław Podolec, Piotr Śmielak-Korombel, Wanda Tracz, Wiesława Kawecka-Jaszcz, Kalina Pająk, Andrzej Arch Med Sci Clinical Research INTRODUCTION: Patients with established coronary artery disease (CAD) are at high risk of recurrent cardiovascular events. The aim of the analysis was to compare time trends in the extent to which cardiovascular prevention guidelines have been implemented by primary care physicians and specialists. MATERIAL AND METHODS: Five hospitals with cardiology departments serving the city and surrounding districts in the southern part of Poland participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after hospitalization. The surveys were carried out in 1997–1998, 1999–2000, 2006–2007 and 2011–2013. RESULTS: The proportion of smokers increased from 16.0% in 1997–1998 to 16.4% in 2011–2013 among those who declared that a cardiologist in a hospital outpatient clinic decided about the treatment, from 17.5% to 34.0% (p < 0.01) among those treated by a primary care physician, and from 7.0% to 19.7% (p = 0.06) among patients treated in private cardiology practices. The corresponding proportions were 44.6% and 42.4% (p < 0.01), 47.7% and 52.8% (p = 0.53), 44.2% and 42.2% (p = 0.75) for high blood pressure, and 42.5% and 71.2% (p < 0.001), 51.4% and 79.6% (p < 0.001), 52.4% and 72.4% (p < 0.01) for LDL cholesterol level not at recommended goal. The proportion of patients prescribed cardioprotective medications increased in every analyzed group. CONCLUSIONS: The control of cardiovascular risk in CAD patients has only slightly improved since 1997/98 in all health care settings. The greatest potential for further improvement was found among patients whose post-hospital care is provided by primary care physicians. It is associated with promotion of a no-smoking policy and enhanced prescription of guideline-recommended drugs. Termedia Publishing House 2017-01-19 2018-08 /pmc/articles/PMC6111342/ /pubmed/30154878 http://dx.doi.org/10.5114/aoms.2017.65236 Text en Copyright: © 2017 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Clinical Research Jankowski, Piotr Czarnecka, Danuta Badacz, Leszek Bogacki, Piotr Dubiel, Jacek S. Grodecki, Janusz Grodzicki, Tomasz Maciejewicz, Janusz Mirek-Bryniarska, Ewa Nessler, Jadwiga Piotrowski, Wiesław Podolec, Piotr Śmielak-Korombel, Wanda Tracz, Wiesława Kawecka-Jaszcz, Kalina Pająk, Andrzej Practice setting and secondary prevention of coronary artery disease |
title | Practice setting and secondary prevention of coronary artery disease |
title_full | Practice setting and secondary prevention of coronary artery disease |
title_fullStr | Practice setting and secondary prevention of coronary artery disease |
title_full_unstemmed | Practice setting and secondary prevention of coronary artery disease |
title_short | Practice setting and secondary prevention of coronary artery disease |
title_sort | practice setting and secondary prevention of coronary artery disease |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111342/ https://www.ncbi.nlm.nih.gov/pubmed/30154878 http://dx.doi.org/10.5114/aoms.2017.65236 |
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