Prevalence of coronary risk factors and efficiency of secondary prevention in patients over 60. years of aged after acute coronary syndrome
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 2
Abstract
Introduction: Prevention of coronary hearty disease in elderly patients is often neglected due to co-existing diseases and socioeconomic factors.The aim: Of this study was to examine coronary risk factors and effectiveness of secondary prevention in patients over 60 after acute coronary syndrome (ACS).Materials and results:We included 185 patients, age 59-90 (mean-69.7), 4-12 months after ACS (ST – elevation myocardial infarction (STEMI) 57.8%, NSTEMI 42.2%), of which 2/3 have had percutaneous transluminal coronary angioplasty (PTCA) with stenting and 1/3 coronary artery bypass grafting (CABG). On acute presentation with ACS – 80% patients had poorly controlled or undiagnosed coronary risk factors. The knowledge of prophylaxis was also low, 75% didn't know the values of normal blood pressure, cholesterol and glycemia.During 12 months of observational period in our outpatient clinic we noted a reduction in risk factors, hypertension reduction from 69.4% to 13%, hyperlipidemia from 76% to 11%, hyperglycemia from 26.4% to 14%, sedentary patients from 73% to 27%, diet non-compliance from 92% to 14%.There was a coronary risk factors reduction by 30-50% from occurrence of ACS to the first visit in our outpatient clinic, mainly due to pharmacotherapy (around 97% patients were taking all 5 main groups of drugs: beta-adrenolytics, ACE-inhibitors, statins, double anti-platelet therapy). Further reduction by 30-50% was due to intensive educational programme during 12-months of observational period. The results for obesity and smoking reduction were unsatisfactory.During the one year observation there was an incidence of 33 cardiovascular events, including 8 serious.Conclusions:1. In the majority of patients ACS was due to lack of effective primary prevention – around 80% patients have had several undiagnosed or poorly controlled coronary risk factors. 2. The majority of coronary risk factors is easy to control, which, in combination with interventional treatment, gives good prognosis for elderly patients with ACS.
Authors and Affiliations
Jolanta Wołkanin-Bartnik, Hanna Pogorzelska
Keywords
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