Vnitr Lek 2018, 64(12):1190-1199

The changes in cardiovascular prevention practice between 1995-2017 in the Czech Republic: a comparison of EUROASPIRE I, II, III, IV and V study

Otto Mayer jr^1,2,*, Jan Bruthans^1,3, Martina Rychecká¹

¹ II. interní klinika LF UK a FN Plzeň

² Biomedicínské centrum LF UK v Plzni

³ Centrum kardiovaskulární prevence 1. LF UK a Thomayerovy nemocnice, Praha

Background:
Appropriate secondary prevention after myocardial infarction is at least similarly important than the manage-ment of acute phase. A serie of EUROASPIRE surveys evaluated the real implementation of secondary prevention principles (as defined by current "Guidelines") into clinical practice in stable coronary heart disease (CHD) patients. This analysis presented changes in adherence to recommended principles overtime, between 1995 and 2017 in Czech cohorts of EUROASPIRE project.

Methods:
Five independent descriptive surveys were undertaken in 1995/1996, 1999/2000, 2006/2007, 2012/2013 and 2016/2017. Consecutive patients suffering for acute coronary event and/or revascularization procedure were identified and examined at least 6 months afterwards.

Results:
The study population included 5 cohorts of 331, 410, 489, 493 and 406 patients. The prescription of basic pharmacotherapy markedly improved, namely use of statins increased more than 12 times (from 7 to 92 %). Proportion of patients who underwent revascularization increased from 49 % to 94 %. Prevalence of hypercholesterolemia and raised blood pressure significantly decreased from 98 % to 52 %, and from 64 % to 49 %, respectively. Proportion of active smokers did not change significantly. Prevalence of overt diabetes increased more than twice between 1995 and 2006, while decreased again afterwards (but still remained higher than baseline prevalence).

Conclusion:
Despite that the adherence to recommendations for secondary prevention markedly improved in single factors, global achievement of desired target remained far from being optimal.

Keywords: coronary heart disease; EUROASPIRE; guidelines; mortality; secondary prevention

Received: November 5, 2018; Accepted: November 15, 2018; Published: December 1, 2018  Show citation