[Profile of risk factors modification after coronary revascularization in patients with coronary artery disease].
OBJECTIVE
To elucidate the profile of risk factors modification after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in patients with coronary artery disease in order to scale the gap between real world practice and evidence-based guidelines.


METHODS
3767 patients with at least 30 days' followed-up after discharge in the single-center DESIRE (Drug-Eluting Stent Impact on REvascularization) registry were enrolled to compare in-hospital and follow-up data including smoking, body weight, blood pressure, fasting blood sugar and lipid levels.


RESULTS
Of the 3763 patients, 3017 (80.2%) were successfully followed up for at least one month with a median of 670 (35 - 1930) days. During follow-up, 18.5% (170/917) of the in-hospital current smokers continued smoking, whereas 6.1% (71/1168) of the non-current smokers during hospitalization became cigarette addict despite a marked reduction in the general rate of current smoking (43.5% vs 9.5%, P < 0.0001). At follow-up, 24.3% (264/1087) of the overweight or obese patients experienced weight gain after revascularization. In patients with diabetes mellitus, 48.3% (143/296) had higher follow-up levels of average fasting blood sugar. In patients complicated with hypertension, 33.1% (469/1419) and 31.9% (453/1419) had higher average systolic or diastolic pressures than in-hospital measurements. During follow-up, 36.4% (111/184) had lower levels of serum high-density lipoprotein cholesterol (HDL-C), whereas 54.1% (98/181) and 56.8% (121/213) patients had higher levels of serum low-density lipoprotein cholesterol (LDL-C) and triglycerlin (TG).


CONCLUSIONS
Risk factors modification after coronary revascularization is far beyond optimal, with a high rate of continued smoking and poor control of body weight, blood sugar, blood pressure and serum lipids. Prompt and effective measures should be taken to enhance the secondary prevention and patient education to minimize the gap between clinical practice and evidence-based guidelines.
Nie
Shao-ping
SP
Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Liu
Xiao-hui
XH
Du
Xin
X
Kang
Jun-ping
JP
Lü
Qiang
Q
Dong
Jian-zeng
JZ
Gu
Cheng-xiong
CX
Huang
Fang-jiong
FJ
Zhou
Yu-jie
YJ
Li
Zhi-zhong
ZZ
Chen
Fang
F
Lü
Shu-zheng
SZ
Wu
Xue-si
XS
Ma
Chang-sheng
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D054855:Drug-Eluting Stents; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D009765:Obesity / Q000503:physiopathology; D011182:Postoperative Care / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D012907:Smoking
D001786:Blood Glucose; D002784:Cholesterol