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Prevalence of Recurrent Cardiac Events Among Patients Attending a Secondary Prevention Clinic Presented by Raid Rabai- NS /king Abdul-Aziz medical city Co-author:- , M. Ghidan, I. Farah, T.Conboy, M.B.Bdeir Disclosers - None


Background 

Coronary artery disease (CAD) is one of the leading causes of death world wide. Recurrent events and progression of CAD is associated with higher rates of morbidity and mortality . Risk of a second cardiovascular event is 5–7 times greater than the general population. (1)

(1) National Cholesterol Education Program. Second report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).  Circulation.1994;89:1333-1445.


Background ď‚Ž

Prevalence of coronary artery disease (CAD) in Saudi population age 30-70 years is 5.5%. Up to date no studies investigates the prevalence of recurrent cardiac events among Saudi patients whom being followed up closely in a secondary prevention clinic. (1)

ď‚Ž

(1) Saudi Medical Journal 2004; Vol. (9): 1165-1171


Objective ď‚Ž

ď‚Ž

Primary objective to study the prevalence of recurrent cardiac events and progression of disease in adult Saudi population diagnosed with CAD and being monitored in a secondary prevention clinic at King Abdul Aziz Medical City (KAMC) Riyadh. Secondary objective to identify patients with high risk for recurrent events


Method 

Retrospective descriptive study which included all patients diagnosed with Ischemic Heart Disease with Ejection Fraction (EF) >40% and had at least one clinical follow up in 2012 after one year of 1st cardiac event. Patient’s data was extracted from computerized database between January 2001 and September 2012.


Method Recurrent event was defined as any CAD progression required intervention after 1st event . ď‚Ž Statistical analysis was performed using SPSS, version 16 ď‚Ž


Statistical Analysis ď‚Ž

ď‚Ž

Results were expressed as count and proportion (%) for categorical variables and compared with Chi square testing. The overall prevalence of recurrent event and risk factor components were associated with 95% confidence interval.


Cardiovascular Disease Management Program (CVDMP) CVDMP is a secondary Prevention Program includes:  Heart Failure Program  Atherosclerosis Program  Diabetes Program  Cardiac Rehabilitation Program


CVDMP Goal of Treatment 

  

Slow the progression of CAD and reduce the incidence of heart attacks Medication management and drug adherence Monitoring of symptoms and early warning signs Continuous support and education


CVDMP      

Nurse Led Target Oriented Physician supervised program Multidisciplinary team work Open door policy Comprehensive management.


Patients Characteristics Total patients number: Age Male Gender Diabetic Hypertension Dyslipidemia Smoker Metabolic Syndrome Obesity

1609 62Âą 10.7 (1281)80% (1197) 74% (1216) 76% (1416) 88% (445) 28% (1274) 79% (858) 53%


Results


Prevalence of Recurrent Cardiac Events


Recurrent Events and Gender P = 0.221


Event and DM


Event and HBA1c


Event and HTN


Event and SBP


Event and HR


Event and LDL


Event and LDL


Event and Metabolic Syndrome


Event and Obesity


Event and Physical Activity


Event and Smoking


Discussion Recurrent and progression of CAD occurred in 12.7% of patients which expected to be higher (25-35%) according to International prevalence of recurrent CAD event (5-7times ) with relation to prevalence of CAD in the Saudi population (5.5%)


Discussion

  

The most Significant risk factors associated with recurrent events and progression of disease: MS DM LDL


Conclusion ď‚Ž

ď‚Ž

The study supports the hypothesis that the better risk factors were controlled , the less recurrent events Most significant risk factors that lead to recurrent events can be controlled by lifestyle modification and medication adherence


Thank You


SHA24/058005