BRNO Register 2: post-myocardial infarction pharmacotherapy

Czech version

Authors: J. Špinar ¹; O. Ludka ¹; M. Sepši ¹; J. Schildberger ¹; L. Dušek ²; J. Jarkovský V Zastoupení Řešitelů Registru Brno ^{2 2}
Authors‘ workplace: Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MU Dr. Jindřich Špinar, CSc., FESC2Institut biostatistiky a analýz Lékařské a Přírodovědecké fakulty MU Brno, ředitel doc. RNDr. Ladislav Dušek, Ph. D. ¹
Published in: Vnitř Lék 2010; 56(6): 533-540
Category: 65th Birthday - Petr Svacina, MD

Overview

We assessed 850 patients with a history of myocardial infarction > 1 month ago who attended outpatient clinics of the Clinic of Internal Medicine and Cardiology at the Faculty Hospital Brno between 1st September 2009 and 31st December 2009. There were more men (650 vs. 200) and patients under 70 years of age (576 vs. 264) in the cohort. 87.8% of patients experienced one myocardial infarction only and the mean age at the first infarction was 59.0 years in men and 65.5 in women (p < 0.001). 75.8% of patients had been prescribed all recommended pharmacotherapeutic groups according to guidelines (RAAS blockers, beta-blockers, statins, antiagregation agents) and each group individually was used in > 90% of patients. There were no differences between men and women and older and younger patients. ACE inhibitors and statins were not always prescribed in recommended (high) doses. Perindopril was the most frequently prescribed ACE inhibitor and atorvastatin the most frequently prescribed statin. Blood pressure of < 140/90 mm Hg was identified in 60.1% of patients, 75% of men and 65% of women had cholesterol level of < 5 mmol/l and > 50% of patients had cholesterol ≤ 4.5 mmol/l, metabolic syndrome was found in about 1/2 of patients and smoking was admitted by 12.5% of patients.

Key words:
myocardial infarction – ACE inhibitor – statin – blood pressure – cholesterol

Sources

1. Šimon J et al. Epidemiologie a prevence ischemické choroby srdeční. Praha: Grada Publishing 2001.

2. Špinar J, Vítovec J et al. Ischemická choroba srdeční. Praha: Grada Publishing 2003.

3. Widimský J Jr, Cífková R, Špinar J et al. Doporučení diagnostických a léčebných postupů arteriální hypertenze – verze 2007. Doporučení České společnosti pro hypertenzi. Vnitř Lék 2008; 54: 101– 118.

4. Yusuf S, Teo KK, Pogue J et al. ONTARGET investigators. Telmisartan, ramipril or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547– 1559.

5. Pfeffer MA, McMurray JJ, Velazquez EJ et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 2003; 349: 1893– 1906.

6. Vítovec J, Špinar J. Je kombinace inhibitorů ACE a blokátorů receptorů pro angiotenzin II v léčbě kardiovaskulárních onemocnění indikovaná? Remedia 2009; 19: 149– 152.

7. Alderman MH. The return on INVEST. JAMA 2003; 290: 2859– 2861.

8. Effect of verapamil on mortality major events after acute myocardial infarction (The Danish Verapamil Infarction Trial II – DAVIT II). Am J Cardiol 1990; 66: 779– 785.

9. Vaverková H, Soška V, Rosolová H et al. Doporučení pro diagnostiku a léčbu dyslipidémií v dospělosti, vypracované výborem České společnosti pro aterosklerózu. Vnitř Lék 2007; 53: 181– 197.

10. Wallentin L, Becker R, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361: 1045– 1057.

11. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001– 2015.

12. Yusuf S, Sleight P, Pogue J et al. Effects of an angiotensin‑converting‑enzyme inhibitor, ramipril, on cardiovascular events in high‑risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342: 145– 153.

13. Fox KM. EURopean trial on reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double‑blind, placebo‑ controlled, multicentre trial (the EUROPA study). Lancet 2003; 362: 782– 788.

14. Braunwald E, Domanski MJ, Fowler SE et al. PEACE Trial Investigators. Angiotensin‑converting‑enzyme inhibition in stable coronary artery disease. N Engl J Med 2004; 351: 2058– 2068.

15. Pilote L, Abrahamowicz M, Rodrigues E et al. Mortality rates in elderly patients who different angiotensin‑converting enzyme inhibitors after acute myocardial infarction: a class effect? Ann Intern Med 2004; 141: 102– 112.

16. Hansen ML, Gislason GH, Køber L et al. Different angiotensin‑converting enzyme inhibitors have similar clinical efficacy after myocardial infarction. Br J Clin Pharmacol 2007; 65: 217– 223.

17. Dickstein K, Kjekshus J. OPTIMAAL Steering Committee of the Study Group. Effects of losartan and captopril on mortality and morbidity in high‑risk patients after acute myocardial infarction: the OPTIMAAL randomised trial. Optimal Trial in Myocardial Infarction with Angiotensin II Antagonist Losartan. Lancet 2002; 360: 752– 760.

18. Yusuf S, Teo KK, Pogue J et al. ONTARGET investigators. Telmisartan, ramipril or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547– 1559.

19. Yusuf S, Teo KK, Anderson C et al. TRANSCEND Investigators. Effects of the angiotensin‑receptor blocker telmisartan on cardiovascular event in high risk patients intolerant to angiotensin‑converting enzyme inhibitors: a randomised controlled trial. Lancet 2008; 372: 1174– 1183.

20. Pfeffer MA, McMurray JJ, Velazquez EJ et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 2003; 349: 1893– 1906.

21. Nissen 1 SE, Tuzcu EM, Schoenhagen P et al. REVERSAL Investigators. Effect of intensive compared with moderate lipid‑ lowering therapy on progression of coronary atherosclerosis. A randomized controlled trial. JAMA 2004; 291: 1071– 1080.

22. Pedersen TR, Faergeman O, Kastelein JJ et al. High‑dose atorvastatin versus usual‑dose simvastatin for secondary prevention after myocardial infarction. The IDEAL study: a randomized controlled trial. JAMA 2006; 294: 2437– 2445.

23. Sabatine MS, Cannon CP, Gibson CM et al. Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST‑elevation myocardial infarction treated with fibrinolytics: the PCI‑ CLARITY study. JAMA 2005; 294: 1224– 1232.

24. Tejc M, Hlinomaz O. Nová data o clopidogrelu – studie CLARITY‑ TIMI 28, COMMIT‑ CCS2 a ARMYDA‑ 2. Interv Akut Kardiol 2005; 4: 154– 158.

25. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001– 2015.

26. Špinar J, Vítovec J. Komu zvoní hrana. Kardiol Rev 2009; 11: 197– 199.

27. Kotseva K, Wood D, De Backer G et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 2009; 373: 929– 940.

28. Mayer O Jr, Šimon J, Galovcová M et al. Úroveň sekundární prevence ischemické choroby srdeční u českách pacienců ve studii EUROASPIRE III. Cor Vasa 2008; 50: 156– 162.

29. Nerbrand C, Lidfeldt J, Nyberg P et al. Serum lipids and lipoproteins in relation to endogenous female sex and age. The Women’s Health in the Lund Area (WHILA) study. Maturitas 2004; 48: 161– 169.

30. Špinar J, Ludka O, Šenkyříková M et al: Hladiny cholesterolu v závislosti na věku. Vnitř Lék 2009; 55: 724– 729.

31. Mancia G, Laurent S, Agabiti‑ Rosei L et al. Reappraisal of European guidelines on hypertension management: a European Society of hypertension Task Force document. J Hypertens 2009; 27: 2121– 2158.

32. Task Force Members 2007. Guidelines for the management of arterial hypertension. J Hypertension 2007; 25: 1105– 1187.

33. Kjekshus J, Apetrei E, Barrios V et al. CORONA Group. Rosuvastatin in older patients with systolic heart failure. N Engl J Med 2007; 357: 2248– 2261.

34. Hradec J. Máme léčit nemocné se srdečním selháním statiny? Výsledky klinické studie CORONA. Remedia 2008; 8: 176– 179.