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. 2019 Aug 29;137(3):223-233.
doi: 10.1590/1516-3180.2018.0531140319.

Secondary prevention of coronary heart disease: a cross-sectional analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Marina Gabriela Birck  1 , Alessandra Carvalho Goulart  2 , Paulo Andrade Lotufo  3 , Isabela Martins Benseñor  4
Affiliations

Secondary prevention of coronary heart disease: a cross-sectional analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Marina Gabriela Birck et al. Sao Paulo Med J. .

Abstract

Background: Coronary heart disease (CHD) remains a major cause of mortality worldwide and in Brazil. Use of standard medications after CHD has been proven to avoid new events and reduce early mortality.

Objectives: This study aimed to analyze secondary prevention of CHD and its association with the baseline characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Design and setting: Cross-sectional analysis on ELSA-Brasil data.

Methods: Secondary prevention of CHD recommended in standard guidelines (antiplatelet plus beta-blocker plus lipid-lowering drug, with or without angiotensin-converting enzyme inhibitors, ACEI, or angiotensin receptor blockers, ARB) was evaluated in relation to sociodemographic data and the time since the coronary event. The chi-square test, one-way analysis of variance (ANOVA) and Mann-Whitney test were performed, as necessary.

Results: Among 15,094 participants, 2.7% reported a previous diagnosis of CHD. Use of recommended drugs for secondary prevention was reported by almost 35% of the participants. Medication use for secondary prevention was generally more frequent among high-income participants than among low-income participants. Use of ARB and ACEI was different between participants who had private health insurance and those who only used the public healthcare system. Men were more likely to use medication than women. The frequency with which participants used the recommended drugs was similar in all time periods after CHD, but use of only one drug increased progressively across time periods.

Conclusion: The use of medication for secondary prevention of CHD was lower than what is recommended in standardized guidelines, especially among women and lower-income participants.

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Conflict of interest statement

Conflict of interests: None

References

    1. GBD 2016 Causes of Death Collaborators Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–1210. doi: 10.1016/S0140-6736(17)32152-9. - DOI - PMC - PubMed
    1. Santos IS, Goulart AC, Brandão RM, et al. One-year mortality after an acute coronary event and its clinical predictors: The ERICO study. Arq Bras Cardiol. 2015;105(1):53–64. doi: 10.5935/abc.20150044. - DOI - PMC - PubMed
    1. Ergatoudes C, Thunstrom E, Rosengren A, et al. Long-term secondary prevention of acute myocardial infarction (SEPAT) - guidelines adherence and outcome. BMC Cardiovasc Disord. 2016;16(1):226–226. doi: 10.1186/s12872-016-0400-6. - DOI - PMC - PubMed
    1. Piegas LS, Timerman A, Nicolau JC, et al. III Diretriz sobre tratamento do infarto agudo do miocárdio [III Guidelines on the treatment of myocardial acute infarction] Arq Bras Cardiol. 2004;83(4):1–86. doi: 10.1590/S0066-782X2004002200001. - DOI - PubMed
    1. Lima RC, Kubrusly LF, Nery ACS, et al. Sociedade Brasileira de Cardiologia. Diretrizes da Cirúrgia de Revascularização Miocárdica [Guidelines for myocardial revascularization surgery]. Arq Bras Cardiol. 2004;82(5):1–20. - PubMed