Secondary prevention in outpatients with coronary artery disease. Adherence with recommendations within 4 weeks after hospital discharge

摘要

BACKGROUND AND OBJECTIVES: There is little information about adherence with secondary preventive medication by patients with coronary artery disease (CHD) shortly after hospital discharge. PATIENTS AND METHODS: History, coronary risk factors, antithrombotic and medication for secondary prevention were recorded on 4643 outpatients (mean age 66 [59 - 72] years, 70 % males) on a two-page case form when attending their general practitioner within four weeks of discharge from hospital. RESULTS: The patients had stable CHD (33 % of patients), ST elevation myocardial infarction (25 %) or a non-ST elevation acute coronary syndrome (42 %). The discharge recommendation given to them by the hospital had the greatest influence on the decision to take medications for secondary prevention. Dual antiplatelet therapy was planned for 3 - 6 months in 35 % of the patients and for 9 - 12 months in another 35 %. Beta-blockers were given to 83 %, ACE-inhibitors to 71 %, AT1 inhibitors to 22 % and statins to 84 %. Gender anddiabetes had a significant impact on the intensity of secondary preventive measures. CONCLUSIONS: Secondary preventive measures were largely adhered to in ambulatory patients with CHD within 4 weeks after hospital discharge. However, there is room for improvement, especially in women.