Document Detail


Secondary prevention for coronary artery disease.
MedLine Citation:
PMID:  14976269     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Secondary prevention of coronary artery disease is effective in reducing morbidity and mortality, but deficiencies in implementation and prescription bias have been identified. Aim: To assess progress in secondary prevention measures for coronary heart disease and whether there was a difference between patient subgroups with angina, post myocardial infarction or revascularization. DESIGN: Retrospective analysis. METHODS: Between 1997 and 2001, data were collected on prophylactic prescribing, demographic and lifestyle information, at baseline and 1 year following attendance at a hospital-based, cardiac-nurse-led out-patient clinic. RESULTS: Patients (n = 945) were entered into the database at hospital discharge and 619 (72%) attended at 1 year. Aspirin and statin prescribing increased, though ACE inhibitor use was less. Mean total cholesterol at baseline reduced to 4.92 +/- 0.11 mmol/l (p < 0.001) in 2000, with a further reduction to 4.59 +/- 0.08 mmol/l at the 1-year visit in 2001 (p < 0.001). The proportion of patients with total cholesterol < 5 mmol/l increased to 38% in 2000, reaching 70% in 2001. Smokers at baseline were similar at around 30%, although this had reduced to 10% in 2001 (p < 0.001). No change in weight was seen for patients with BMI >or=30 (p = NS). No significant differences were seen between patient subgroups (p = NS). DISCUSSION: Secondary prevention measures are improving, especially in prophylactic prescribing, lipid management and smoking cessation, although scope for further improvement remains. No difference was seen between the patient subgroups. Lifestyle measures need to be addressed to gain maximum benefit in addressing overall cardiovascular risk.
Authors:
A L McLeod; L Brooks; V Taylor; P F Currie; N G Dewhurst
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  97     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-20     Completed Date:  2004-04-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  127-31     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ninewells Hospital, Dundee, UK. a.mcleod@ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage
Aspirin / administration & dosage
Cholesterol / blood
Coronary Artery Disease / prevention & control*
Drug Utilization
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
Middle Aged
Outpatient Clinics, Hospital
Platelet Aggregation Inhibitors / administration & dosage
Retrospective Studies
Smoking Cessation / statistics & numerical data
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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