Comparison of in-hospital secondary prevention for different vascular diseases.
BACKGROUND
Secondary prevention of coronary artery disease is highly effective and implemented on a large scale. However, studies testing adherence to recommended secondary prevention of other vascular diseases are rare. Our goal was to evaluate whether the kind of vascular disease influences prescription practice of secondary drug prophylaxis at hospital discharge and to which extent secondary prevention is actually complete.


METHODS
A 3-month prospective observational review of the hospital discharge information of all patients hospitalized because of a vascular disease diagnosis: coronary artery disease (i.e. acute myocardial infarction [AMI] and chronic stable angina [CSA]); peripheral artery disease [PAD] and cerebrovascular disease [CVD]. The analysis was done by board registered internists with a structured form that founded on internationally accepted recommendations.


RESULTS
From 271 patients 191 had coronary artery disease (105 AMI and 86 CSA), 88 PAD and 72 CVD. Global prescription rate (mean; 95% CI) of indicated secondary prophylaxis drugs was 74.1% (69.9-78.2) for AMI, 72.4% (67.2-77.5) for CSA, 74.7% (68.8-80.7) for PAD and 72.1% (66.9-77.3) for CVD. The proportion of patients who were prescribed a complete bundle of recommended medications was globally 29.5% (24.1-35.0).


CONCLUSIONS
We found similar global prescription rates of secondary prevention for the different vascular diseases. However, only one third of the studied collective gets a complete set of required prophylactic drugs.
Perren
Andreas
A
Intensive Care Unit, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland. andreas.perren@eoc.ch
Cerutti
Bernard
B
Lazzaro
Mario
M
Donghi
Davide
D
Previsdomini
Marco
M
Marone
Claudio
C
D000368:Aged; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055502:Secondary Prevention; D014652:Vascular Diseases / Q000517:prevention & control*