Evaluation of secondary prevention in Egyptian patients after primary percutaneous coronary intervention

Abstract

\n \n \n Type of funding sources: None.\n \n \n \n Effective secondary prevention after acute coronary syndromes is critical to reducing the risk of a subsequent cardiovascular event.\xa0 Adherence to secondary prevention is disappointingly\xa0low worldwide, with no\xa0data in Upper Egypt.\xa0\n \n \n \n \xa0We sought to determine the prevalence of adherence to secondary preventive\xa0among patients who underwent primary percutaneous coronary intervention (PPCI) in a tertiary centre in Upper Egypt from 2014-2016\xa0(n\u2009=\u2009468).\n \n \n \n \xa0Our cohort included 468\xa0patients, mean age\xa0 at\xa0STEMI was 55.7\u2009±\u200911.2 years; 79% males. Smoking, diabetes mellitus\xa0(DM), dyslipidemia,\xa0obesity and hypertension were 62%, 42%, 39%, 38% and 34% respectively. Median follow-up duration (IQR) was 703 (613-830) days. Table 1 shows the prevalence of adherence secondary prevention. Re-myocardial infarction, unstable angina, repeated hospital admission was 4.9%, 5.1%, 14% respectively. \xa0Revascularizations were 8.1% and total\xa0ischemic complications\xa0\xa0were 18%.\xa0The major adverse cardiac events MACEs\xa0were 24%.\xa0DM and hypertension were significant predictors of MACEs\xa0on univariable and multivariable analysis (multivariable ORs [95% CIs]: 1.685\xa0[1.002 -2.833] and 1.764\xa0[1.033-3.012], respectively).\xa0\n \n \n \n \xa0Adherence to secondary prevention after PPCI is sub-optimal in Upper Egypt.\xa0We need to raise the standard of preventive cardiology care through more effective primary and secondary prevention programs,\xa0to reduce morbidity and mortality.\n Risk factor Target level Number (%) Diabetes HbA1c <7% 280(62) Blood pressure <140/90 295(63) Smoking cessation in smokers Complete cessation 122 (43) Smoking status No smoking 301(65) Physical activity Walking at least 30 minutes 5 days/week 301(60) Body mass index <25 kg/m2 101(22) Waist circumference <102 cm in males, <88 cm in females 164(36) Diet Low salt and fat, adequate fruits and vegetables 268 (57) Lipids LDL < 70 gm/dL 93(26)\n