Using a standardized follow-up program to improve coronary heart disease secondary prevention.

objectiveTo reveal the current status and effectiveness of a standardized follow-up of the secondary prevention of coronary heart disease (CHD) at Peking University First Hospital.

methodsThe study group comprised 496 patients diagnosed with CHD between January 1, 2007 and December 31, 2009 after a standardized follow-up program began. A group of 300 patients with CHD diagnosed between January 1, 2004 and December 31, 2004 was evaluated as the control group. The study group participants were followed-up every 3 months for 1 year in the outpatient department and were interviewed by telephone between November 2012 and January 2013. Data on the control of risk-factors, medical therapy, and clinical events were collected.

resultsAt discharge, 75.4% of the study group patients were non-smokers, 51.4% exercised regularly, 42.4% were overweight, 56.7% had blood pressure <140/90 mm Hg (<130/80 in those with diabetes mellitus), 51% had serum low-density-lipoprotein cholesterol <2.60 mmol/L, and 64.2% had fasting plasma glucose <6.11 mmol/L. Antiplatelet medication was used by 99.4% of the study group patients, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers by 64.5%, beta-blockers by 79.1%, and statins by 94.3%. Major adverse cardiac events, the primary clinical outcome, occurred in 22.7% of the study group patients. The proportions of non-smokers (82.2% vs. 73.7%, p=0.014), control of serum lipids (84.4% vs. 45.6%, p<0.001), and use of statins (92.5% vs. 54.3%, p<0.001) at the end of follow-up were significantly greater in the study group than those in the control group.

conclusionAlthough some patients with CHD were still not achieving the goals of lifestyle change, control of risk factors, and medication therapy, standardized follow-up helped improve and standardize CHD secondary prevention.