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Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry.
Eur J Prev Cardiol 2015; 22(12):1548-56EJ

Abstract

BACKGROUND

To describe drug adherence and treatment goals, and to identify the independent predictors of smoking persistence and unsatisfactory lifestyle habits six months after an acute myocardial infarction (AMI).

METHODS AND RESULTS

11,706 patients with AMI (30% female, mean age 68 years) were enrolled in 163 large-volume coronary care units (CCUs). At six months, drug adherence was ≥90%, while blood pressure (BP) <140/90 mmHg, low density lipoprotein (LDL) <100 mg/dl (in patients on statins), HbA1c <7% (in treated diabetics), and smoking persistence were observed in 74%, 76%, 45%, and 27% of patients, respectively. Inadequate fish intake decreased from 73% to 55%, inadequate intake of fruit and vegetables from 32% to 23%, and insufficient exercise in eligible patients from 74% to 59% (p < 0.0001). At multivariable analysis, a post-discharge cardiac visit and referral to cardiac rehabilitation at follow-up were independently associated with a lower risk of insufficient physical exercise (odds ratio (OR) 0.71 and 0.70, respectively) and persistent smoking (OR 0.68 and 0.60), whereas only referral to cardiac rehabilitation was associated with a lower risk of inadequate fish and fruit/vegetable intake (OR 0.70 and 0.65).

CONCLUSIONS

Six months after an AMI, despite a high adherence to drug treatments, BP, LDL, and diabetic goals are inadequately achieved. Subjects with healthy lifestyles improved after discharge, but the rate of those with regular exercise habits and adequate fish intake could be further improved. Access to post-discharge cardiac visit and referral to cardiac rehabilitation were associated with better adherence to healthy lifestyles. Knowledge of the variables associated with specific lifestyle changes may help in tailoring secondary prevention programmes.

Authors+Show Affiliations

Ospedale Bellaria, Department of Cardiology, Bologna, Italy.Ospedale Ca' Foncello, Department of Cardiology, Treviso, Italy.ANMCO Research Center, Florence, Italy.Ospedale Alessandro Manzoni, Department of Cardiology, Lecco, Italy.A.O.U. S. Giovanni di Dio - Ruggi D'Aragona, UOC UTIC, Salerno, Italy.Azienda Ospedaliera di Perugia, Department of Cardiology, Perugia, Italy.IRCCS Az Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Department of Cardiology, Genova, Italy.Azienda Ospedaliero-Universitaria Policlinico, Department for the Treatment of Cardiovascular Diseases, Modena, Italy.Ospedale Campo di Marte, Department of Cardiology, Lucca, Italy.ANMCO Research Center, Florence, Italy centrostudi@anmco.it.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25452625

Citation

Urbinati, Stefano, et al. "Secondary Prevention After Acute Myocardial Infarction: Drug Adherence, Treatment Goals, and Predictors of Health Lifestyle Habits. the BLITZ-4 Registry." European Journal of Preventive Cardiology, vol. 22, no. 12, 2015, pp. 1548-56.
Urbinati S, Olivari Z, Gonzini L, et al. Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. Eur J Prev Cardiol. 2015;22(12):1548-56.
Urbinati, S., Olivari, Z., Gonzini, L., Savonitto, S., Farina, R., Del Pinto, M., ... Maggioni, A. P. (2015). Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. European Journal of Preventive Cardiology, 22(12), pp. 1548-56. doi:10.1177/2047487314561876.
Urbinati S, et al. Secondary Prevention After Acute Myocardial Infarction: Drug Adherence, Treatment Goals, and Predictors of Health Lifestyle Habits. the BLITZ-4 Registry. Eur J Prev Cardiol. 2015;22(12):1548-56. PubMed PMID: 25452625.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. AU - Urbinati,Stefano, AU - Olivari,Zoran, AU - Gonzini,Lucio, AU - Savonitto,Stefano, AU - Farina,Rosario, AU - Del Pinto,Maurizio, AU - Valbusa,Alberto, AU - Fantini,Giuseppe, AU - Mazzoni,Alessandra, AU - Maggioni,Aldo P, AU - ,, Y1 - 2014/12/01/ PY - 2014/07/10/received PY - 2014/11/08/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2016/8/31/medline KW - Acute myocardial infarction KW - cardiac rehabilitation KW - drug adherence KW - lifestyle KW - physical exercise KW - secondary prevention SP - 1548 EP - 56 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 22 IS - 12 N2 - BACKGROUND: To describe drug adherence and treatment goals, and to identify the independent predictors of smoking persistence and unsatisfactory lifestyle habits six months after an acute myocardial infarction (AMI). METHODS AND RESULTS: 11,706 patients with AMI (30% female, mean age 68 years) were enrolled in 163 large-volume coronary care units (CCUs). At six months, drug adherence was ≥90%, while blood pressure (BP) <140/90 mmHg, low density lipoprotein (LDL) <100 mg/dl (in patients on statins), HbA1c <7% (in treated diabetics), and smoking persistence were observed in 74%, 76%, 45%, and 27% of patients, respectively. Inadequate fish intake decreased from 73% to 55%, inadequate intake of fruit and vegetables from 32% to 23%, and insufficient exercise in eligible patients from 74% to 59% (p < 0.0001). At multivariable analysis, a post-discharge cardiac visit and referral to cardiac rehabilitation at follow-up were independently associated with a lower risk of insufficient physical exercise (odds ratio (OR) 0.71 and 0.70, respectively) and persistent smoking (OR 0.68 and 0.60), whereas only referral to cardiac rehabilitation was associated with a lower risk of inadequate fish and fruit/vegetable intake (OR 0.70 and 0.65). CONCLUSIONS: Six months after an AMI, despite a high adherence to drug treatments, BP, LDL, and diabetic goals are inadequately achieved. Subjects with healthy lifestyles improved after discharge, but the rate of those with regular exercise habits and adequate fish intake could be further improved. Access to post-discharge cardiac visit and referral to cardiac rehabilitation were associated with better adherence to healthy lifestyles. Knowledge of the variables associated with specific lifestyle changes may help in tailoring secondary prevention programmes. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/25452625/Secondary_prevention_after_acute_myocardial_infarction:_drug_adherence_treatment_goals_and_predictors_of_health_lifestyle_habits__The_BLITZ_4_Registry_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487314561876?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -