Evidence-based therapy prescription in high-cardiovascular risk patients: the REACT study.
| Autor: | Berwanger O; Hospital do Coração, São Paulo, SP., Piva e Mattos LA, Martin JF, Lopes RD, Figueiredo EL, Magnoni D, Precoma DB, Machado CA, Guimarães JI, Andrade JP |
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| Jazyk: | English; Portuguese |
| Zdroj: | Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2013 Mar; Vol. 100 (3), pp. 212-20. |
| DOI: | 10.5935/abc.20130062 |
| Abstrakt: | Background: Data on outpatient care provided to patients at high cardiovascular risk in Brazil are insufficient. Objective: To describe the profile and document the clinical practice of outpatient care in patients at high cardiovascular risk in Brazil, regarding the prescription of evidence-based therapies. Methods: Prospective registry that documented the ambulatory clinical practice in individuals at high cardiovascular risk, which was defined as the presence of the following factors: coronary artery disease, cerebrovascular and peripheral vascular diseases, diabetes, or those with at least three of the following factors: hypertension, smoking, dyslipidemia, age > 70 years, family history of coronary artery disease, chronic kidney disease or asymptomatic carotid artery disease. Basal characteristics were assessed and the rate of prescription of pharmacological and non-pharmacological interventions was analyzed. Results: A total of 2364 consecutive patients were included, of which 52.2% were males, with a mean age of 66.0 years (± 10.1). Of these, 78.3% used antiplatelet agents, 77.0% used statins and of patients with a history of myocardial infarction, 58.0% received beta-blockers. Concomitant use of these three classes of drugs was 34%; 50.9% of hypertensive, 67% of diabetic and 25.7% of dyslipidemic patients did not achieve the goals recommended by guidelines. The main predictors of prescription therapies with proven benefit were centers with a cardiologist and history of coronary artery disease. Conclusion: This national and representative registry identified important gaps in the incorporation of therapies with proven benefit, offering a realistic outlook of patients at high cardiovascular risk. |
| Databáze: | MEDLINE |
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