Importance of Secondary Prevention in Coronary Heart Disease

Figures

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  Figure 1. Comparison of patient characteristics between Romanian and European study groups. Compared with the European SURF cohort, our center’s patients were younger and more often admitted with ACS, with substantially higher PCI and lower CABG rates. These differences likely reflect center-level practice patterns and case mix rather than national trends and should be interpreted within a single-center context.

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  Figure 2. Education level. The cohort skews toward secondary education, and higher body weight is more frequent in lower education strata, consistent with socio-educational gradients reported elsewhere. As this is a single-center, largely urban sample, these gradients may not mirror rural populations. Distribution by highest completed education in the Romanian cohort (N = 136). Values are %.

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  Figure 3. Weight differences among education level. Body weight (kg) across education strata. Units: kg.

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  Figure 4. Comparison of inclusion diagnosis between Romania, the region (Europe) and overall (worldwide) expressed as percentage. The predominance of ACS at presentation in our clinic suggests a referral pattern favoring acute presentations. This may contribute to the observed preference for PCI and should not be generalized to other Romanian regions or levels of care. Acute coronary syndrome (ACS) and stable angina pectoris (SAP) at inclusion, shown as % of cohort. Denominators: Romania N = 136; Europe N = 3586.

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  Figure 5. Lipid profile. Mean LDL-C and total cholesterol were higher in our cohort than region-wide descriptive reports, consistent with the low proportion meeting LDL targets. This identifies a clear target for intensifying lipid-lowering therapy and follow-up. Mean (SD) LDL-C, total cholesterol, HDL-C, and triglycerides in mg/dL. (SI: mmol/L = mg/dL ÷ 38.67 for cholesterol fractions; ÷ 88.57 for triglycerides).

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  Figure 6. Risk factors target attainment. Within our cohort, attainment was lowest for BMI and waist circumference targets and modest for LDL-C and blood pressure. We now report explicit denominators (n/N) for each target in Supplementary Table S1 and footnotes to Figure 6. Because SURF-CHD European denominators are incomplete/heterogeneous, we present European values descriptively only and avoid inferential comparisons for these outcomes. Targets: non-smoking; physical activity ≥ 30 min, 3–5×/week; BMI < 25 kg/m2; waist circumference < 94 cm (men), <80 cm (women); BP < 140/90 mmHg (or <140/85 mmHg if diabetes); LDL-C < 70 mg/dL (1.8 mmol/L); HbA1c < 7% in diabetics.