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Multicenter Study
. 2024 Jul 24;13(7):537-545.
doi: 10.1093/ehjacc/zuae066.

Patient knowledge about risk factors, achievement of target values, and guideline-adherent secondary prevention therapies 12 months after acute myocardial infarction

Uwe Zeymer  1   2   3 , Franz Goss  3   4   5 , Marcel Kunadt  2 , Susanne Oldenburg  5 , Mathias Hochadel  2 , Holger Thiele  6   7 , Karl Werdan  3   7   8 ; GULLIVE-R Investigators
Collaborators, Affiliations
Multicenter Study

Patient knowledge about risk factors, achievement of target values, and guideline-adherent secondary prevention therapies 12 months after acute myocardial infarction

Uwe Zeymer et al. Eur Heart J Acute Cardiovasc Care. .

Abstract

Aims: The prospective GULLIVE-R study aimed to evaluate adherence to guideline-recommended secondary prevention, physicians' and patients' estimation of cardiac risk, and patients' knowledge about target values of risk factors after acute myocardial infarction (AMI).

Methods and results: We performed a prospective study enrolling patients 9-12 months after AMI. Guideline-recommended secondary prevention therapies and physicians as well as patients' estimation about their risk and patients' knowledge about target values were prospectively collected. Between July 2019 and June 2021, a total of 2509 outpatients were enrolled in 150 German centres 10 months after AMI. The mean age was 66 years, 26.4% were women, 45.3% had ST elevation myocardial infarction, 54.7% had non-ST elevation myocardial infarction, and 93.6% had revascularization (84.0% percutaneous coronary intervention, 7.4% coronary artery bypass graft, 1.8% both). Guideline-recommended secondary drug therapies were prescribed in over 80% of patients, while only about 50% received all five recommended drugs (aspirin, P2Y12 inhibitors, statins, beta-blockers, renin-angiotensin-aldosterone system inhibitors), and regular exercise was performed by only one-third. About 90% of patients felt well informed about secondary prevention, but the correct target value for blood pressure was known in only 37.9% and for LDL-cholesterol in only 8.2%. Both physicians and patients underestimated the objective risk of future AMIs as determined by the thormbolysis in myocardial infarction (TIMI) risk score for secondary prevention.

Conclusion: There is still room for improvement in patient education and implementation of guideline-recommended non-pharmacological and pharmacological secondary prevention therapies in patients in the chronic phase after AMI.

Keywords: Acute myocardial infarction; Guidelines; Patient education; Secondary prevention.

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Conflict of interest statement

Conflict of interest: U.Z.: Speaker honoraria from Astra Zeneca, Amgen, Boehringer Ingelheim, Bayer Healthcare, BMS, Daiichi Sankyo, Eli Lilly, Ferrer, Medicines Company, MSD, Novartis, Sanofi. F.G.: Research support from Astra Zenca. M.K., S.O., M.H., H.T., and K.W.: none.

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