Survival of Patients with Acute Coronary Syndrome who Receive Secondary Prevention Therapy: A Single-center Cohort Study

Background and Purpose: Secondary prevention for patients with acute coronary syndrome is recommended by international guidelines; however, lifestyle intervention is an underutilized component. The purpose of this study was to determine the use of optimal secondary prevention therapy in a single-center and to assess how the survival and characteristics of patients correlate with optimal therapy. Methods: We included patients with acute coronary syndrome who underwent percutaneous coronary intervention from January 2012 to June 2013. Patients received dual antiplatelet therapy during follow-up, and they were allocated to an optimal or a suboptimal therapy cohort. The optimal therapy cohort received additional diet or exercise therapy. Data for clinical events, death, and patients characteristics were collected, and Kaplan-Meier survival analysis and a general linear model were used to determine differences in outcomes between cohorts. Independent t and chi-square tests were used to analyze baseline characteristics. Results: Younger (63±13.3 years of age) men (n=253, 79.1%) populated the optimal therapy cohort (n=320, 80.2%). There was no significant difference in clinical events and mortality rates (0.63% vs. 1.27%, respectively, p=0.359) between cohorts. However, the rate of exercise therapy after discharge in the optimal therapy cohort was low (17.8%). Conclusions: Although we did not detect a significant difference in the rates of clinical events and mortality between cohorts, we believe that lifestyle intervention is insufficient. Further research should therefore focus on extended management after discharge to insure adherence to therapy.