Patient knowledge about risk factors, achievement of target values, and guideline-adherent secondary prevention therapies 12 months after acute myocardial infarction.

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Uwe Zeymer, Franz Goss, Marcel Kunadt, Susanne Oldenburg, Mathias Hochadel, Holger Thiele, Karl Werdan
{"title":"Patient knowledge about risk factors, achievement of target values, and guideline-adherent secondary prevention therapies 12 months after acute myocardial infarction.","authors":"Uwe Zeymer, Franz Goss, Marcel Kunadt, Susanne Oldenburg, Mathias Hochadel, Holger Thiele, Karl Werdan","doi":"10.1093/ehjacc/zuae066","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>The prospective GULLIVE-R study aimed to evaluate adherence to guideline-recommended secondary prevention, physicians' and patients' estimation of cardiac risk, and patients' knowledge about target values of risk factors after acute myocardial infarction (AMI).</p><p><strong>Methods and results: </strong>We performed a prospective study enrolling patients 9-12 months after AMI. Guideline-recommended secondary prevention therapies and physicians as well as patients' estimation about their risk and patients' knowledge about target values were prospectively collected. Between July 2019 and June 2021, a total of 2509 outpatients were enrolled in 150 German centres 10 months after AMI. The mean age was 66 years, 26.4% were women, 45.3% had ST elevation myocardial infarction, 54.7% had non-ST elevation myocardial infarction, and 93.6% had revascularization (84.0% percutaneous coronary intervention, 7.4% coronary artery bypass graft, 1.8% both). Guideline-recommended secondary drug therapies were prescribed in over 80% of patients, while only about 50% received all five recommended drugs (aspirin, P2Y12 inhibitors, statins, beta-blockers, renin-angiotensin-aldosterone system inhibitors), and regular exercise was performed by only one-third. About 90% of patients felt well informed about secondary prevention, but the correct target value for blood pressure was known in only 37.9% and for LDL-cholesterol in only 8.2%. Both physicians and patients underestimated the objective risk of future AMIs as determined by the thormbolysis in myocardial infarction (TIMI) risk score for secondary prevention.</p><p><strong>Conclusion: </strong>There is still room for improvement in patient education and implementation of guideline-recommended non-pharmacological and pharmacological secondary prevention therapies in patients in the chronic phase after AMI.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Acute Cardiovascular Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjacc/zuae066","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Aims: The prospective GULLIVE-R study aimed to evaluate adherence to guideline-recommended secondary prevention, physicians' and patients' estimation of cardiac risk, and patients' knowledge about target values of risk factors after acute myocardial infarction (AMI).

Methods and results: We performed a prospective study enrolling patients 9-12 months after AMI. Guideline-recommended secondary prevention therapies and physicians as well as patients' estimation about their risk and patients' knowledge about target values were prospectively collected. Between July 2019 and June 2021, a total of 2509 outpatients were enrolled in 150 German centres 10 months after AMI. The mean age was 66 years, 26.4% were women, 45.3% had ST elevation myocardial infarction, 54.7% had non-ST elevation myocardial infarction, and 93.6% had revascularization (84.0% percutaneous coronary intervention, 7.4% coronary artery bypass graft, 1.8% both). Guideline-recommended secondary drug therapies were prescribed in over 80% of patients, while only about 50% received all five recommended drugs (aspirin, P2Y12 inhibitors, statins, beta-blockers, renin-angiotensin-aldosterone system inhibitors), and regular exercise was performed by only one-third. About 90% of patients felt well informed about secondary prevention, but the correct target value for blood pressure was known in only 37.9% and for LDL-cholesterol in only 8.2%. Both physicians and patients underestimated the objective risk of future AMIs as determined by the thormbolysis in myocardial infarction (TIMI) risk score for secondary prevention.

Conclusion: There is still room for improvement in patient education and implementation of guideline-recommended non-pharmacological and pharmacological secondary prevention therapies in patients in the chronic phase after AMI.

急性心肌梗死发生 12 个月后,患者对风险因素的了解、目标值的实现以及对二级预防疗法指南的遵守情况。
目的:前瞻性 GULLIVE-R 研究旨在评估急性心肌梗死(AMI)后对指南推荐的二级预防的依从性、医生和患者对心脏风险的估计以及患者对风险因素目标值的了解:我们对急性心肌梗死后 9-12 个月的患者进行了前瞻性研究。前瞻性地收集了指南推荐的二级预防疗法、医生和患者对自身风险的估计以及患者对目标值的了解:结果:2019 年 7 月至 2021 年 6 月期间,共有 2509 名门诊患者在急性心肌梗死 10 个月后在德国 150 个中心登记。平均年龄为 66 岁,26.4% 为女性,45.3% 为 STEMI,54.7% 为 NSTEMI,93.6% 接受过血管再通术(84.0% PCI,7.4% CABG,1.8% 两者都接受过)。80%以上的患者接受了指南推荐的辅助药物治疗,但只有约50%的患者接受了所有五种推荐药物(阿司匹林、P2Y12抑制剂、他汀类药物、β-受体阻滞剂、RAAS抑制剂),只有三分之一的患者进行了定期锻炼。约 90% 的患者认为自己充分了解二级预防知识,但只有 37.9% 的患者知道正确的血压目标值,只有 8.2% 的患者知道正确的低密度脂蛋白胆固醇目标值。医生和患者都低估了二级预防的 TIMI 风险评分所确定的未来急性心肌梗死的客观风险:在急性心肌梗死后的慢性期患者中,患者教育和指南推荐的非药物和药物二级预防疗法的实施仍有待改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信