title: [Secondary Preventive Program of atherosclerosis in a university hospital. Results and predictors of clinical course].
abstract: OBJECTIVE
  Lipid therapeutic goals are not achieved in a high percentage of patients with coronary artery disease (CAD). We describe in this paper the methodology and results of the Hospital Universitario de Bellvitge Atherosclerosis Secondary Preventive Program (PPSHB), which is aimed at preventing ischemic recurrences by controlling atherogenic factors.
  
  
  METHODS
  From January 1992 to December 1996, 882 patients with acute CAD entered the PPSHB and were seen on at least 2 occasions at the Unidad de Lípidos y Arteriosclerosis during a mean period of 10.4 (3.8) months. In 753 patients data on clinical follow-up were available. Follow-up data were collected by telephone interview and review of medical records.
  
  
  RESULTS
  During the follow-up period at the Unidad de Lípidos y Arteriosclerosis, 71.9% of patients achieved the therapeutic goals or their LDLc improved >= 15%. These results were seen in 83.6%, 78.7% and 83.6% of patients with regard to HDLc, triglycerides and HDLc/LDLc ratio, respectively, while the percentage of patients receiving lipid-lowering drugs increased from 28% to 69%. During a follow-up of 33.7 (15.9) months, death (all causes; mean survival time: 20 [13.4] months) occurred in 41 patients (5.4%). On the other hand, hospitalization for cardiovascular disease was required in 113 patients (15%) during a mean follow-up until the first admission of 18.4 (14.2) months. The main independent predictor of unfavourable clinical course was not to reach the HDLc/LDLc ratio goal (HDLc/LDLc >= 0.27 or an increase >= 15%; OR = 2.1; 95% CI, 1.1-4.03).
  
  
  CONCLUSIONS
  A systematic secondary preventive strategy may help achieve an adequate control of dyslipidemia in most CAD patients. In these patients, achieving the HDLc/LDLc therapeutic goal is associated with a less than half risk of hospitalization for cardiovascular disease or death from any cause.
authors.affiliation: Unitat de Lípids i Arteriosclerosi. Servei de Medicina Interna. Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat. Barcelona. xpinto@csub.scs.es
authors.forename: Xavier
authors.initials: X
authors.lastname: Pintó
authors.forename: José F
authors.initials: JF
authors.lastname: Meco
authors.forename: Emili
authors.initials: E
authors.lastname: Corbella
authors.forename: Rosaura
authors.initials: R
authors.lastname: Figueras
authors.forename: Carlos
authors.initials: C
authors.lastname: Pallarés
authors.forename: Enric
authors.initials: E
authors.lastname: Esplugas
authors.forename: María J
authors.initials: MJ
authors.lastname: Castiñeiras
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Ramon
authors.initials: R
authors.lastname: Pujol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000097:blood / Q000517:prevention & control*; D003327:Coronary Disease / Q000097:blood / Q000517:prevention & control*; D003625:Data Collection; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D008055:Lipids