PREMISE: Secondary prevention of myocardial infarction and health-related quality of life

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Substantial evidence from randomized controlled trials reveals that pharmacological interventions in people with established ischemic coronary events notably reduces the risk of cardiovascular mortality and morbidity. The objective of this study was to assess potential control level of modifiable risk factors as well as of prophylactic treatment and quality of life in patients with a first myocardial infarction. METHOD: Prospective, 2-years follow-up study, carried out in 4 public hospitals and in their corresponding primary care centers in Catalonia. RESULTS: We included 618 patients (76% males) with a mean age of 64 years. Patients were mostly followed up by both general practitioners and cardiologists. Prevalence of risk factors was as follows: 54% patients had hypercholesterolemia, 41% were hypertensive, 11% smokers, 76% had overweight and 19% were obese. With regard to the prophylactic treatment, lipid lowering drugs were prescribed in 52% of patients, beta-blockers in 50%, antiplatelet drugs in 87%, ACE inhibitors in 32%, nitrates in 52%, calcium antagonists in 31% and oral anticoagulants in 8% of patients. Mean scores of the quality of life questionnaire were 5.34, 5.42 and 5.63 for emotional role, physical role and social role, respectively; the subgroup of patients who were hospitalized during the follow up had worse scores. CONCLUSIONS: There is still a considerable potential to gain in the secondary prevention of myocardial infarction with regard to the prophylactic treatment and the control of risk factors. Health-related quality of life in patients, two years after the first myocardial infarction, is fairly good, although differences between subgroups are observed.