The importance of cardiac rehabilitation programmes in the control of LDL cholesterol after an acute coronary syndrome
| Autor: | N Barja Gonzalez, JS Hevia Nava, P Florez Llano, A Adeba Garcia, R Alvarez Velasco, V Barriales Alvarez, M Soroa Ortuno, A Junco Vicente, J Santamaria Rubio, R Fernandez Asensio, J Cuevas Perez, M Vigil-Escalera Diaz, María Martín Fernández, A Martinez Leon, YR Persia Paulino |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Ldl cholesterol
Acute coronary syndrome medicine.medical_specialty Ejection fraction Rehabilitation Epidemiology business.industry medicine.medical_treatment medicine.disease Complex regional pain syndrome Ezetimibe Diabetes mellitus Internal medicine medicine Cardiology LDL Cholesterol Lipoproteins Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Journal of Preventive Cardiology. 28 |
| ISSN: | 2047-4881 2047-4873 |
| DOI: | 10.1093/eurjpc/zwab061.282 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Introduction and objectives Cardiac rehabilitation programmes (CRP) are a fundamental pillar in the education, optimization of treatment and assessment of the functional class in cardiovascular pathology. The aim of this study is to analyse the levels of LDL cholesterol at discharge and after 6 months of follow-up after the CRP carried out in our centre. Material and methods Analysis of a prospective cohort of 268 patients, included in the CRP between November 2015 and October 2018 after an acute coronary event and with a minimum follow-up of 6 months. The CRP consists of a medical and nursing consultation both for inclusion and prior to discharge. It lasts 1 month and includes 3 weekly sessions of individualised and monitored exercise which are carried out together with talks on cardiovascular risk factors, diet, treatments... In the pre-discharge consultation, an analysis is carried out to adjust the treatment, and a new control is performed after 6 months. Results Average age 56.2 years (SD: 8.9), 90% men, 46% hypertense, 24% diabetics, 68% dyslipemics, 70% smokers/ex-smokers and 57% sedentary. 60% of the patients had presented a STEMI, with 80% being revascularized percutaneously. 48% had 1-vessel disease. LVEF was conserved in 74% of the patients. The mean LDL cholesterol after the event is 105.3 mg/dl (SD: 37.7) and at the discharge of the program, 61 mg/dl (SD: 21.3) being the difference statistically significant (p 55 mg/dl, after the same 55 % and at 6 months 57% (graph 1). After 6 months, 4% maintained levels >100 mg/dl. 98% of patients were receiving high-potency statins and 12% ezetimibe. At discharge, treatment with ezetimibe was started in 28 patients (13%). No treatment with iPCSK9 was initiated. This study was carried out while the 2016 European guidelines were still in effect, with an LDL target in secondary prevention of less than 70 mg/dl. Conclusions CRPs are effective in improving control of LDL cholesterol, due to a closer monitoring and a better health education that allows greater therapeutic adherence. However, after the programme it is necessary to continue with regular monitoring to maintain and, in some cases, reach the target figures. In our case there is a small percentage of patients who could still benefit from starting treatment with iPSCK9. Abstract Figure. Graph 1 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|