CLINICAL RESEARCH
Treatment goal attainment for secondary prevention in coronary patients with or without diabetes mellitus – Polish multicenter study POLASPIRE
 
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1
Department of Cardiology, School of Health Sciences, Medical University of Silesia, Poland
2
I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
3
Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
4
Department of Cardiology and Hypertension with the Electrophysiological Lab, Central Research Hospital the Ministry of the Interior and Administration, Warsaw, Poland
5
Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
6
Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
7
Department of Public Health and Primary Care, Ghent University, Belgium
8
Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London and National Institute of Preventive Cardiology, National University of Ireland-Galway, Galway, Ireland
9
Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
Submission date: 2019-07-25
Final revision date: 2019-09-12
Acceptance date: 2019-09-22
Online publication date: 2020-01-23
 
 
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ABSTRACT
Introduction:
Cardiovascular disease is still a leading cause of death in Poland and across Europe. The aim of this study was to assess the attainment of the main treatment goals for secondary cardiovascular prevention in coronary patients with or without diabetes mellitus (DM) in Poland.

Material and methods:
The study group included 1026 patients (65.5 ±9 y.o.; males: 72%) included at least 6 months after the index hospitalisation for myocardial infarction, unstable angina, elective percutaneous coronary intervention or coronary artery bypass surgery. The target and treatment goals were defined according to the 2016 European Society of Cardiology guidelines on cardiovascular prevention.

Results:
Patients with DM (n = 332; 32%) were slightly older compared to non-diabetic (n = 694) individuals (67.2 ±7 vs. 64.6 ±9 years old; p < 0.0001). The DM goal was achieved in 196 patients (60%). The rate of primary (LDL: 51% vs. 35%; p < 0.0001) and secondary (non-HDL: 56% vs. 48%; p < 0.02) goal attainment was higher in DM(+) compared to DM(–) patients. The rate of target blood pressure was lower in DM(+) than in normoglycemic patients (52% vs. 61% at < 140/90 mm Hg, p < 0.01. As expected, goal achievement of normal weight (9.5% vs. 19%; p < 0.0001) and waist circumference (7% vs. 15%; p < 0.001) was lower in diabetic patients and the rate of regular physical activity was similar (DM+ 12% vs. DM– 14%; p = ns). Finally, there was no difference in active smokers (DM+ 23% vs. DM– 22%; p = ns).

Conclusions:
Great majority of Polish patients in secondary prevention do not achieve treatment goals. Although lipid goals attainment is better in DM and the rate of smokers is similar, the management of all risk factors needs to be improved.

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