Sekundärprävention der koronaren Herzkrankheit in der Arztpraxis

Abstract

There is little information about adherence with secondary preventive medication by patients with coronary artery disease (CHD) shortly after hospital discharge. History, coronary risk factors, antithrombotic and medication for secondary prevention were recorded on 4643 outpatients (mean age 66 [59 - 72] years, 70 % males) on a two-page case form when attending their general practitioner within four weeks of discharge from hospital. The patients had stable CHD (33 % of patients), ST elevation myocardial infarction (25 %) or a non-ST elevation acute coronary syndrome (42 %). The discharge recommendation given to them by the hospital had the greatest influence on the decision to take medications for secondary prevention. Dual antiplatelet therapy was planned for 3 - 6 months in 35 % of the patients and for 9 - 12 months in another 35 %. Beta-blockers were given to 83 %, ACE-inhibitors to 71 %, AT1 inhibitors to 22 % and statins to 84 %. Gender and diabetes had a significant impact on the intensity of secondary preventive measures. Secondary preventive measures were largely adhered to in ambulatory patients with CHD within 4 weeks after hospital discharge. However, there is room for improvement, especially in women.