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. 2012 Feb 29;8(1):57-62.
doi: 10.5114/aoms.2012.27282.

Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice

Anthony D Mercando  1 , Hoang M Lai, Wilbert S Aronow, Phoenix Kalen, Harit V Desai, Kaushang Gandhi, Mala Sharma, Harshad Amin, Trung M Lai
Affiliations

Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice

Anthony D Mercando et al. Arch Med Sci. .

Abstract

Introduction: Although atherosclerotic disease cannot be cured, risk of recurrent events can be reduced by application of evidence-based treatment protocols involving aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statin medications. We studied atherosclerotic event rates in a patient population treated before and after the development of aggressive risk factor reduction treatment protocols.

Material and methods: We performed a retrospective chart review of patients presenting for follow-up treatment of coronary artery disease in a community cardiology practice, comparing atherosclerotic event rates and medication usage in a 2-year treatment period prior to 2002 and a 2-year period in 2005-2008. Care was provided in both the early and later eras by 7 board-certified cardiologists in a suburban cardiology practice. Medication usage was compared in both treatment eras. The primary outcome was a composite event rate of myocardial infarction, cerebrovascular events, and coronary interventions.

Results: Three hundred and fifty-seven patients were studied, with a follow-up duration of 12.1 (±3.5) years. There were 132 composite events in 104 patients (29.1%) in the early era compared to 40 events in 33 patients (9.2%) in the later era (p < 0.0001). From the early to the later eras, there was an increase in use of β-blockers (66% to 83%, p < 0.0001), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (34% to 80%, p < 0.0001), and statins (40% to 90%, p < 0.0001).

Conclusions: Application of aggressive evidence-based medication protocols for treatment of atherosclerosis is associated with a significant decrease in atherosclerotic events or need for coronary intervention.

Keywords: atherosclerosis; cardiovascular drugs; cerebrovascular events; myocardial infarction.

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Figures

Figure 1
Figure 1
Percent of patients with events in early era and later era MI – myocardial infarction, PCI – percutaneous coronary intervention, CABG – coronary artery bypass grafting
See this image and copyright information in PMC

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