Preventive counselling and dynamics of behavioral risk factors in patients during 12-months after underwent myocardial infarction

Modification of risk factors (RFs) can substantially reduce the probability of recurrent adverse cardiovascular events. It is imperative to evaluate the prevalence and changes in RFs both before and after a myocardial infarction (MI), as well as the effectiveness of their modification, particularly in the context of preventive counseling. Objective. To analyze the incidence of modifiable risk factors associated with recurrent adverse cardiovascular events in patients with a myocardial infarction, prior to and within 12 months following the event, and to examine the relationship between preventive counseling and alterations in risk factors. Materials and methods. This study enrolled 1.099 patients with MI, aged 35 to 75, using a specialized randomization regimen. During the in-patient phase, the status and intensity of smoking were assessed, alongside an evaluation for alcohol dependence utilizing the CAGE scale (Cut down, Annoyed, Guilty, Eye-opener Questionnaire). Following 12 months, data were collected regarding the implementation of preventive counseling and changes in the risk factor profile, including smoking, alcohol consumption, physical activity (PA), and dietary habits. Results. Prior to experiencing MI, 44.0% of patients were smokers. After 12 months, the proportion of smokers decreased significantly to 34.5% (p<0.001), reflecting a 9.5% reduction. The intensity of smoking markedly declined, with a 48.9% reduction in the number of male subjects consuming more than 20 cigarettes per day (p<0.001). Alcohol dependence was reported in 11% of patients before MI, while within the subsequent year, 43.9% of patients reported a reduction in alcohol consumption. Post-MI, 52.8% of patients maintained their diet, whereas only 23.2% increased their intake of vegetables and fruits, 1.5% increased their intake of fish, and 13.5% reduced their intake of sugary and fatty foods. There was no change in physical activity for 53.2% of patients, while 40.2% decreased their activity levels; only 5.3% reported an increase in PA. Preventive counseling conducted as part of post-MI follow-up was positively associated with improved risk factor profiles, reflecting significant reductions in smoking frequency and intensity (OR 6.21; 95% CI 4.00—9.85; p<0.001), alcohol consumption (OR 2.62; 95% CI 1.52—4.61; p<0.001), healthier dietary choices (OR 1.90; 95% CI 1.25—2.91; p=0.003), and increased physical activity (OR 2.30; 95% CI 1.09—4.98; p=0.031). Conclusions. Within the 12 months following myocardial infarction, patients demonstrated an improvement in their risk factor profiles, encompassing smoking, alcohol consumption, and dietary habits. However, the observed changes were not sufficient. Preventive counseling was associated with statistically significant improvements in the risk factor profiles studied.