title: [Krakow Program for Secondary Prevention of Ischaemic Heart Disease. Part III. Secondary prevention of ischaemic heart disease after discharge].
abstract: Even though the majority of actions undertaken within the secondary prevention of ischaemic heart disease should be initiated while the patient is still hospitalized, the maximum benefit (measured as decreased cardiovascular risk) achieved depends mostly on the continuation and modification of these actions in the postdischarge period. There is not much known about the quality of medical care provided for patients after hospitalization due to ischaemic heart disease. The aim of the study was to assess the quality of postdischarge care in the field of secondary prevention of ischaemic heart disease.
  
  
  METHODS
  Consecutive patients (age > or = 70 years; residing in the Cracow province) were identified according to the following clinical diagnoses or procedures: acute myocardial infarction, unstable angina, CABG and PCI. Out of 536 patients 418 took part in the control visit 6-18 months after discharge. Risk factors and medication used were assessed.
  
  
  RESULTS
  High total cholesterol (> or = 5.2 mmol/l) was found in 65.8% of patients, high blood pressure (> or = 140/90 mmHg) in 46.2%, obesity (BMI > or = 30 kg/m2) in 24.6%, fasting glucose over 6.0 mmol/l in 17.7% and smoking in 16.3%. The frequency of antiplatelet drugs and beta-blockers use decreased whereas that of lipid-lowering drugs increased in the postdischarge period. The highest frequency of use of antiplatelets and lipid-lowering drugs, as well as the best control of hypercholesterolemia was found in the PCI group, whereas the lowest frequency of smoking was found in the CABG group.
  
  
  CONCLUSIONS
  Insufficient control of risk factors and the frequency of secondary prevention using drugs was found. There is a need to intensify secondary prevention in patients with ischaemic heart disease in the postdischarge period.
authors: I Klinika Kardiologii Instytutu Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego, ul. Kopernika 17, 31-501 Kraków.
authors: K
authors: K
authors: Kawecka-Jaszcz
authors: P
authors: P
authors: Jankowski
authors: A
authors: A
authors: Pajak
authors: J
authors: J
authors: Dubiel
authors: J
authors: J
authors: Maciejewicz
authors: W
authors: W
authors: Piotrowski
authors: W
authors: W
authors: Smielak-Korombel
authors: W
authors: W
authors: Tracz
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000328:Adult; D000359:Aftercare / Q000592:standards*; D000368:Aged; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D010351:Patient Discharge; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011044:Poland / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors