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Review
. 2019 Jul 27;8(8):1114.
doi: 10.3390/jcm8081114.

Long-Term Risk Factor Control After Myocardial Infarction-A Need for Better Prevention Programmes

Rico Osteresch  1 , Andreas Fach  1 , Johannes Schmucker  1 , Ingo Eitel  2 , Harald Langer  2 , Rainer Hambrecht  1 , Harm Wienbergen  3   4
Affiliations
Review

Long-Term Risk Factor Control After Myocardial Infarction-A Need for Better Prevention Programmes

Rico Osteresch et al. J Clin Med. .

Abstract

Introduction: Long-term prognosis of myocardial infarction (MI) is still serious, especially in patients with MI and cardiogenic shock. To improve long-term prognosis and prevent recurrent events, sustainable cardiovascular risk factor control (RFC) after MI is crucial.

Methods: The article gives an overview on health care data regarding RFC after MI and presents recent trials on modern preventive strategies that support patients to achieve risk factor targets during long-term course.

Results: International registry studies, such as EUROASPIRE, observed alarming deficiencies in RFC after MI. As data of the German Bremen ST-segment elevation myocardial infarction (STEMI)-Registry show, most deficiencies are found in socially disadvantaged city districts and in young patients. Several studies on prevention programmes to improve RFC after MI reported inconsistent data; however, in the recently published IPP trial a 12-months intensive prevention programme that included both repetitive personal contacts with non-physician prevention assistants and telemetric risk factor control, was associated with significant improvements of numerous risk factors (smoking, LDL and total cholesterol, systolic blood pressure and physical inactivity).

Conclusions: There is a strong need of action to improve long-term risk RFC after MI, especially in socially disadvantaged patients. Modern prevention programmes, using personal and telemetric contacts, have large potential to support patients in achieving long-term risk factor targets after coronary events.

Keywords: myocardial infarction; prevention programmes; risk factor control; socially disadvantaged districts.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Socioeconomic status and incidence of STEMIs. Postal codes of home addresses of STEMI-patients in the city of Bremen/Germany and a social deprivation index were used to group patients into different categories of socioeconomic status. A negative association between low socioeconomic status and STEMI-incidence was observed with most STEMIs in socially disadvantaged city districts (G3, G4).
Figure 2
Figure 2
Prevention success and prevention failure associated with 12 months intensive prevention programme (IPP) vs. usual care (UC).
Figure 3
Figure 3
Strategies to increase attractiveness of long-term prevention programmes.
See this image and copyright information in PMC

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