Efficacy over time of a short overall atherosclerosis management programme on the reduction of cardiovascular risk in patients after an acute coronary syndrome.
BACKGROUND
The prognostic significance of monitoring risk factors and adjusting treatments in patients after an acute coronary syndrome (ACS) is well documented. However, studies over the last few years show that secondary prevention objectives are rarely met. Prevention programmes are effective but their benefit is only partially maintained in long-term follow-up.


OBJECTIVE
To evaluate the efficacy of a global management programme for atherosclerosis (the CEPTA programme) on the long-term monitoring of cardiovascular risk factors, on adherence to treatment, and to compare the data of clinical events post-ACS with that contained in the scientific literature.


METHODS
Six hundred and sixty consecutive patients were hospitalised three months after the occurrence of an ACS to evaluate residual risk factors, the atherosclerosis burden, and to undergo a treatment adjustment and a therapeutic and dietary education programme. We evaluated the impact of this long-term programme on the balance of risk factors, treatment maintenance and clinical events. At the end of an average follow-up of 20 months, 96.3% of patients were on antiaggregates, 86.0% were on beta-blockers or Verapamil, 62.4% were on angiotensin-converting enzyme inhibitors or angiotensin to receptor antagonists, 88.4% were on cholesterol-lowering medication and 75.5% were receiving a combination of beta-blocker antiaggregates and cholesterol-lowering drugs. Monitoring of LDL cholesterol and blood pressure was done in over 81 and 71% of patients, respectively. At 20 months of follow-up, total mortality was 3.6% and one cardiovascular event occurred in 12% of patients. In conclusion, this short programme following ACS is beneficial for the long-term management of cardiovascular risk factors and the sustainability of drug treatments.
Lafitte
Marianne
M
Centre d'exploration, de prévention et de traitement de l'athérosclérose (Cepta), hôpital cardiologique du Haut-Levêque, avenue de Magellan, 33604 Pessac cedex, France.
Pradeau
Vincent
V
Leroux
Lionel
L
Richeboeuf
Vincent
V
Tastet
Sandrine
S
Boulon
Carine
C
Paviot
Bertrand
B
Bonnet
Jacques
J
Couffinhal
Thierry
T
D054058:Acute Coronary Syndrome / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D004032:Diet; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D002317:Cardiovascular Agents