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Cardiovascular care follow-up concerns

Thursday January 18th, 2018

European countries are “losing” many patients with chronic cardiovascular disease unnecessarily, according to a major analysis published today.

Researchers found that nearly 25% of these patients are back in hospital or dead within six months of diagnosis – usually because of cardiovascular disease.

The research involved patients at 100 hospitals and clinics in ten European countries and was backed by the European Society of Cardiology.

It was published as a UK analysis, simultaneously, raised concerns about the extent to which patients get access to cardiac rehabilitation programmes.

The European study involved some 2,420 patients with stable coronary disease or peripheral artery disease.

Age was a significant risk factor for rehospitalisation or death – as were peripheral revascularisation, chronic kidney disease and COPD. Living in a southern European country – on the edge of the Mediterranean - was associated with reduced risk.

The study found a significant drop in the taking of anti-hypertension drugs and of aspirin six months after patients were first treated.

Researcher Professor Michel Komajda, of the University Pierre and Marie Curie and Pitié-Salpêtrière Hospital in Paris, France, said: “In absolute numbers the reductions were modest but they did reach statistical significance. This shows that patients have a better chance of receiving recommended medications while in hospital or directly after an outpatient appointment.

“Six months later, drugs they should be taking to reduce the risk of death and rehospitalisation are prescribed less frequently. It is likely that there is insufficient handover of these patients to a cardiologist or GP and so their prescriptions are not renewed.”

Meanwhile in the UK, the National Audit of Cardiac Rehab, conducted by the British Heart Foundation, reported that 68,000 patients missed out on cardiac rehabilitation in one year – 48% of those eligible.

The study found that almost half of those who received rehabilitation had to wait longer than the recommended 28 days.

BHF chief executive Simon Gillespie said: “It is hugely encouraging that overall more patients are accessing cardiac rehabilitation services but half of heart attack survivors are still missing out on this potentially lifesaving service.

“Tens of thousands of people are therefore at greater risk of suffering another deadly heart attack.”

Komajda M, et al. The chronic ischaemic cardiovascular disease ESC Pilot Registry: Results of the six-month follow-up. European Journal of Preventive Cardiology 18 January 2018; doi: 10.1177/2047487317751955

Tags: Europe | Heart Health | Pharmaceuticals | UK News

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