Application of secondary prevention measures in patients with coronary artery disease - Republic Serbia

Aim The aim of this study was to test the implementation of European recommendations for cardiac rehabilitation and secondary prevention programs and investigate the health-related quality of life (HRQoL).in the population of coronary heart disease (CAD) patients from Serbia. Methods A total of 712 consecutive patients (204 women, aged 60.9 ± 9.3 years) [without revascularization-WR (n=162), percutaneous transluminal coronary angioplasty PTCA (n=218), coronary artery bypass graft CABG (n=332)] admitted for specialized cardiovascular rehabilitation, interviewed and examined in relation to the presence of coronary risk factors and administration of secondary prevention measures, were enrolled in the study. HRQoL was estimated using the SF-36 questionnaire for total QoL and its two dimensions for physical and mental health [physical and mental component summary scores (PCS,MCS)]. Sexual dysfunction was assessed using the ASEX scale. Results Our patients were examined in relation to the European population (EUROSPIRE III) higher percentage of smokers (25 vs. 18%) and fewer have reached the target of cholesterol (40 vs. 53%), but were less obese (21% vs. 38%), have better regulation of the BP (83% vs. 39%) and no significant differences in a number of diabetic patients (29% vs. 28%). In the use of medicaments, there were no significant differences. All the recommended drugs for secondary prevention is receiving 55.2% of patients; beta blockers 91.3%, ACE inhibitors 81%, statins 86.8% and aspirin 94%. The results of the present study have clearly demonstrated significantly better HRQoL in men, younger CAD patients, patients who underwent PCI, and patients with previously not self-reported incident, intermittent or permanent stress. After 24 months of monitoring major cardiovascular events were more common in women and patients without revascularization. These patients had been in a number of smokers and less regulated BP They had a poorer quality of life and were more depressed. Conclusions Inadequate change of lifestyle and poor quality of life after coronary events and have a great prognostic value in our patients with CAD.