Adherence to ESC secondary prevention targets following STEMI was suboptimal, with 64% achieving blood pressure <140/90mmHg, 31% achieving LDL <1.4mmol/L, and 43% completing cardiac rehabilitation.
Observational (n=173)
No
Adherence to ESC secondary prevention targets following STEMI in a rural Australian hospital is suboptimal, highlighting the need for structured secondary-prevention pathways.
Abstract Background/Introduction Risk factor modification is central to secondary prevention following ST-elevation myocardial Infarction (STEMI). The 2021 European Society of Cardiology (ESC) guidelines emphasise optimisation of modifiable risk factors - lipids, blood pressure, smoking, diabetes, weight, and cardiac rehabilitation to prevent recurrent events and improve survival.1 Purpose To evaluate adherence to ESC secondary-prevention recommendations among patients admitted with STEMI in 2024 to a hospital which serves rural and remote Far North Queensland. Methods A retrospective audit of all 2024 STEMI patients was performed using hospital electronic records. Each patient’s inpatient baseline was compared with outpatient follow up across smoking status, cessation support, blood pressure (140/90mmHg), lipids (LDL1.4mmol/L and/or ≥50% reduction)2, BMI 25kg/m² or ≥5% weight loss, HbA1c review in diabetics³, and cardiac rehabilitation completion. Outcomes were compared to ESC secondary-prevention targets.1,3 Results Among 173 STEMI patients (27.2% Aboriginal or Torres Strait Islander), 102 had follow-up. Smoking was reported in 52.1%, 97% received counselling, 29.1% accepted nicotine replacement, and 12.5% had quit. Blood pressure 140/90mmHg was achieved in 64%, with optimisation in 39%. Lipid re-testing occurred in 54%, 31% had LDL 1.4mmol/L, 36% ≥50% reduction, and 21% met both. Lipid therapy was intensified in 47%, mainly through ezetimibe addition.2 At review, 39% had BMI 25kg/m², 26% achieved ≥5% weight loss, and 43% completed cardiac rehabilitation. Overall, 47% were pre-diabetic or diabetic, 88% of diabetics were discharged on therapy, with HbA1c re-checked in 71% of diabetics and 37.5% of pre-diabetics.3 Conclusion(s) Partial optimisation of risk factors was achieved, however, full adherence to ESC targets – particularly lipid, weight, diabetes, and rehabilitation goals – remained suboptimal. Strengthened follow up and structured secondary-prevention pathways are warranted for these patients.1,3
Cherian et al. (Mon,) conducted a observational in ST-elevation myocardial infarction (STEMI) (n=173). ESC secondary prevention recommendations was evaluated on Adherence to ESC secondary-prevention targets. Adherence to ESC secondary prevention targets following STEMI was suboptimal, with 64% achieving blood pressure <140/90mmHg, 31% achieving LDL <1.4mmol/L, and 43% completing cardiac rehabilitation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: