Risk factors and therapeutic coverage at 6 years in patients with previous myocardial infarction: the CASTUO study

• Published in: Open heart Vol. 3; no. 1; p. e000368
• Main Authors: Félix-Redondo, Francisco Javier, Lozano Mera, Luis, Consuegra-Sánchez, Luciano, Giménez Sáez, Fernando, Garcipérez de Vargas, Francisco Javier, Castellano Vázquez, José María, Fernández-Bergés, Daniel
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 2016; BMJ Publishing Group
• Series: Original research article
• Subjects: Coronary Artery Disease; MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD); QUALITY OF CARE AND OUTCOMES
• ISSN: 2053-3624; 2398-595X; 2053-3624
• DOI: 10.1136/openhrt-2015-000368

ObjectivesTo determine the degree of risk factor control, the clinical symptoms and the therapeutic management of patients with a history of previous myocardial infarction.MethodsCross-sectional study at 6 years of a first episode of acute myocardial infarction between 2000 and 2009, admitted at a hospital in the region of Extremadura (Spain). Of 2177 patients with this diagnosis, 1365 remained alive and therefore were included in the study.ResultsWe conducted a person-to-person survey in 666 (48.8%) individuals and telephone survey in 437 (31.9%) individuals. The former are analysed. 130 were female (19.5%). The mean age was 67.4 years and the median time since the event was 5.8 (IQR 3.6–8.2) years. Active smokers made up 13.8%, low-density lipoprotein (LDL) cholesterol was ≥70 mg/dL: 82%, blood pressure ≥140/90 mm Hg (≥140/85 in diabetics): 49.8%, fasting glucose ≥126 mg/dL: 26%, heart rate 50–59 bpm: 60.7%, and obesity: 45.9%. Patients reported presenting angina comprised 22.4% and those with dyspnoea, 29.3%. Drug coverage was: 88.0% antiplatelet drugs, 86.5% statins, 75.6% β-blockers and 65.8% blockers of the renin-angiotensin system. Patients receiving all four types of drugs made up 41.9%, with only 3.0% having jointly controlled cholesterol, blood pressure, heart rate and glycaemia.ConclusionsLDL cholesterol, heart rate and blood pressure were risk factors with less control. More than 1/5 of patients had angina and more than 1/4, dyspnoea. Risk factor control and the clinical condition were far from optimal, as was drug coverage, although to a lesser degree.