Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?

Jankowski, Piotr; Czarnecka, Danuta; Łysek, Radosław; Skrzek, Agnieszka; Smaś-Suska, Monika; Mazurek, Adam; Brzozowska-Kiszka, Małgorzata; Wolfshaut–Wolak, Renata; Surowiec, Sławomir; Bogacki, Piotr; Bryniarska-Mirek, Ewa; Bryniarski, Leszek; Grodecki, Janusz; Nessler, Jadwiga; Olszowska, Maria; Podolec, Piotr; Kawecka‐Jaszcz, Kalina; Pająk, Andrzej

doi:10.5603/kp.a2013.0350

Cited by 17 publications

(25 citation statements)

References 17 publications

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“…We analyzed data of participants of five surveys assessing secondary prevention following hospitalization due to CAD carried out in 1997-1998, 1999-2000, 2006-2007, 2011-2013, and 2016-2017 [8][9][10][11][12]. The same five hospitals serving the city and surrounding districts participated in each survey.…”

Section: Methodsmentioning

confidence: 99%

“…The same five hospitals serving the city and surrounding districts participated in each survey. Methods used in surveys were published previously and were similar each time [8][9][10][11][12][13]. Shortly, in each survey the study sample consisted of consecutive patients hospitalized for coronary artery bypass grafting or percutaneous coronary intervention or myocardial infarction or unstable angina.…”

Section: Methodsmentioning

confidence: 99%

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Pharmacotherapy in patients with chronic coronary syndromes over a 20-year period (1997–2017)

Jankowski¹,

Kozieł²,

Bogacki³

et al. 2020

Kardiol Pol

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pharmacotherapy in patients with chronic coronary syndromes over a 20-year period (1997–2017)

Jankowski¹,

Kozieł²,

Bogacki³

et al. 2020

Kardiol Pol

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“…However, the optimal secondary prevention strategy in patients with new onset glucose abnormalities and AMI still has not been thoroughly established. Although nonpharmacological treatment is considered the first-line therapy for new onset glucose abnormalities, published studies have shown unsatisfactory adherence to such management in patients with coronary artery disease, especially with concomitant DM [12,[15][16][17]. Recently, it has been shown that among patients with ST elevation myocardial infarction and without DM, but including patients with prediabetes, subjects who were treated with metformin presented modest improvement of cardiovascular risk profile at four-month follow-up [18].…”

Section: Discussionmentioning

confidence: 99%

Long-term prognosis is related to mid-term changes of glucometabolic status in patients with acute myocardial infarction treated invasively

et al. 2017

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A b s t r a c tBackground: Glucometabolic status (GS) in patients with acute myocardial infarction (AMI) has an impact on prognosis, but it may change over time. Aim:To evaluate the prognosis after AMI treated invasively with respect to changes in GS assessed by oral glucose tolerance test at discharge and at mid-term follow-up visit (FU-visit).Methods: Glucometabolic status was assessed by two-hour post-load glycaemia and defined as abnormal glucose tolerance (AGT) or normal glucose tolerance (NGT). Out of 454 in-hospital AMI survivors, 368 (81%) patients completed an FU-visit and were divided into four groups with respect to GS at discharge and FU-visit: group 1 -AGT at discharge and FU-visit (n = 101); group 2 -AGT at discharge and NGT at FU-visit (n = 48); group 3 -NGT at discharge and AGT at FU-visit (n = 114); and group 4 -NGT at discharge and FU-visit (n = 105). All-cause mortality was compared between groups with log-rank test.Results: Median time from AMI to FU-visit was seven months. Median remote follow-up duration after AMI was 31 months. Two-hour post load glycaemia was significantly higher in patients with confirmed AGT at FU-visit than in other groups. Mortality was higher in group 1 (11.9%) than in group 2 (2.1%; p = 0.034) and group 4 (2.9%; p = 0.009). Mortality rates between group 2 and 4 were similar (2.1% vs. 2.9%; p = 0.781). There was no significant difference in mortality between group 1 and group 3 (11.9% vs. 6.1%; p = 0.114). Mortality in group 3 was over two-fold higher than in group 4; however, this difference was statistically non-significant (6.1% vs. 2.9%; p = 0.247). Conclusions:Prognosis for patients with confirmed AGT was unfavourable; however, patients with AGT at discharge, in whom GS improved, had similar mortality to subjects with persistent NGT. The major clinical implication from this study is the finding that reassessment of GS by repeated oral glucose tolerance test has significant prognostic value and makes initial risk stratification performed at discharge more reliable.

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“…According to this statement the education programme should be started immediately after early rehabilitation, and the patient's first ambulatory control visit should be performed four weeks after ACS. In the meantime, alarming data have been published for Poland, which suggest only modest improvement in the implementation of secondary prevention guidelines in everyday clinical practice for CVD as well as substantial long-term mortality for patients after myocardial infarction [3,4]. Based on these recommendations and worrisome results of poor adherence to secondary prevention measures, a planned programme of a series of educational meetings for patients after ACS was initiated in the form of the Patient Club in nine invasive cardiology centres in Southern and Eastern Poland by the local NGO (Cardiovascular Centre Foundation, Krakow, Poland) independently from rehabilitation schemes that were applied by default.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of an education-based secondary outpatient prevention programme after acute coronary syndrome hospitalisations and treatment in Poland. The Patient Club initiative

et al. 2016

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A b s t r a c tBackground: Guidelines on cardiovascular prevention from the European Society of Cardiology advocate sustained educational measures to be undertaken by both doctors and nurses to ensure lifestyle changes for patients after acute coronary syndromes (ACS). A planned programme of a series of educational meetings for patients after ACS was initiated in form of the Patient Club. Aim:To assess the efficacy of the Patient Club initiative in terms of increased knowledge on cardiovascular risk factors as well as utilisation of healthy lifestyle in patents who attend the programme. Methods:Patients in nine cardiology centres in Poland, who were treated for ACS between October and December 2014, were included. A dedicated questionnaire on healthy lifestyle and knowledge on cardiovascular risk factors was filled in by patients at hospital discharge. In January 2015 the same questionnaire was filled in by the same group of patients before their local Patient Club meeting.Results: There were 1273 patients hospitalised for ACS who were invited to join the Patient Club initiative. Of them, 372 (29%) filled in the questionnaire both at discharge and at the Patient Club meeting. The percentage of patients who smoked cigarettes decreased from 14% to 5% (p < 0.001), and the number of those who had at least 30 min of physical activity daily increased from 50% to 58% (p = 0.015). Conclusions:Patients who attended Patient Club meetings usually four weeks after ACS showed significant benefit in terms of healthy lifestyle changes and more guideline-recommended management of cardiovascular risk factors.

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Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?

Cited by 17 publications

References 17 publications

Pharmacotherapy in patients with chronic coronary syndromes over a 20-year period (1997–2017)

Pharmacotherapy in patients with chronic coronary syndromes over a 20-year period (1997–2017)

Long-term prognosis is related to mid-term changes of glucometabolic status in patients with acute myocardial infarction treated invasively

The efficacy of an education-based secondary outpatient prevention programme after acute coronary syndrome hospitalisations and treatment in Poland. The Patient Club initiative

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