Background In 2005 the Chilean government started a healthcare reform that guarantees medical treatment for patients with acute myocardial infarction (MI), including secondary prevention.
Aim To evaluate the impact of this program in risk factors control and events.
Methods 514 consecutive MI patients hospitalised in six public hospitals. Data collection was obtained by a review of medical records and a 12-month interview (anthropometric and biochemical measurements, lifestyle information and pharmacological treatment). Predictors of good control were evaluated with multilevel analysis.
Results follow-up was available in 398 patients (77.4%), 75% were male, aged 62.1 years (SD ±11.7). At the time of interview 8.6% were smokers; 24% reported regular physical activity; 78.6% were overweight or obese. The proportion of patients with raised systolic blood pressure was 46.3% and raised diastolic blood pressure was found in 35.4%. 28.9% had LDL cholesterol ≥100 mg/dl and 21.1% glucose ≥100 mg/dl. In diabetic patients (24.1%), 52% had glycosilated haemoglobin ≥7.0%. The use of drug therapies at month 12 was: aspirin 95.5%, β-blockers 70.6%, ACE inhibitors 64.0% and statins 89.2%. One year mortality was 6.8%. Predictors for good control of risk factors were statin use (OR 2.64; CI 1.16 to 5.98) and control by cardiologist (OR 1.13; CI 1.01 to 1.27); diabetic patients have a poor control (OR 0.30; CI 0.15 to 0.61).
Conclusion Patients with MI have unhealthy lifestyles and a high proportion not achieved the goal for cholesterol and blood pressure management. A multidisciplinary approach is needed to improve secondary prevention in MI patients.
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