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Multicenter Study
. 2020 Apr;7(1):e001196.
doi: 10.1136/openhrt-2019-001196.

ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK

Catriona S Jennings  1   2 , Kornelia Kotseva  3   2 , Paul Bassett  3 , Agnieszka Adamska  3   2 , David Wood  3   2 ; ASPIRE-3-PREVENT Investigators
Collaborators, Affiliations
Multicenter Study

ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK

Catriona S Jennings et al. Open Heart. 2020 Apr.

Abstract

Objective: To quantify the implementation of the third Joint British Societies' Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.

Methods: Using a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Data were collected using standardised methods and instruments by trained study nurses. Blood was analysed in a central laboratory and a glucose tolerance test was performed.

Results: 3926 eligible patients were invited to participate and 1177 (23.3% women) were interviewed (30% response). 12.5% were from black and minority ethnic groups. 45% were persistent smokers, 36% obese, 52.9% centrally obese, 52% inactive; 30% had a blood pressure >140/90 mm Hg, 54% non-high-density lipoprotein ≥2.5 mmol/L and 44.3% had new dysglycaemia. Prescribing was highest for antiplatelets (94%) and statins (85%). 81% were advised to attend cardiac rehabilitation (86% <60 years vs 79% ≥60 years; 82% men vs 77% women; 93% coronary artery bypass grafting vs 59% unstable angina), 85% attended if advised; 69% attended overall. Attenders were significantly younger (p=0.03) and women were less likely to attend (p=0.03).

Conclusions: Patients with coronary heart disease (CHD) are not being adequately managed after event with preventive measures. They require a structured preventive cardiology programme addressing lifestyle, risk factor management and adherence to cardioprotective medications to achieve the standards set by the British Association for Cardiovascular Prevention and Rehabilitation and JBS3 guidelines.

Keywords: cardiac rehabilitation; delivery of care; epidemiology; hypertension; smoking.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of patients through all phases of data collection in ASPIRE-3-PREVENT. CABG, coronary artery bypass grafting; NSTEMI, non-STEMI; OGTT, oral glucose tolerance test; PTCA, percutaneous transluminal coronary angioplasty; STEMI, ST-elevation myocardial infarction.
Figure 2
Figure 2
Self-reported regular planned exercise.
Figure 3
Figure 3
Glucose metabolism in 1177 patients based on an oral glucose tolerance test in those without self-reported diabetes.
See this image and copyright information in PMC

References

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