Investigation On Risk Factors Management In Outpatients With Coronary Heart Disease

Objective: To investigate the control and management status ofcoronary heartdisease risk factorsand the recommended pharmacotherapy for secondary prevention,inorder to provide a reference for clinicalwork.Methods: By collectingoutpatient or inpatientin First Affiliated Hospital of FujianMedical University during October2013to January2014, who were in coronary heartdisease and diagnosed by coronary angiography,to investigate the mean value and therate meeting the guidelines ofcoronary heart disease risk factors that includecigarettesmoking,bodymass index, heart rate,dyslipidemia, diabetes mellitus andhypertension,andinvestigate the prescription rate of the recommended drug forsecondary prevention after coronary angiography.Results: A total of437subjects were enrolled in this study,the average age of thepatientswho were charged in coronary heart diseasewas about67years with27.1%being female.At the beginning when diagnosedwith coronary heart disease,25.00%ofthe patients were in smoking,and there was no significantreductionat follow-up. At thebeginning, as for BMI,there were45.41%of the patients met the goal of its guideline,and the mean value of heart rate was68.27bpm, there were only13.04%of the patientsmet the goal of its guideline,and both of them had on difference between the beginningand follow-up. As for the dyslipidemia, at the beginning, the mean value of TC was4.40mmol/L,41.04%of the patients met the goal of its guideline,and the mean value ofLDL-C was1.99mmol/L,60.98%of the patients met the goal of its guideline. But atfollow-up from6th month to12th month, there were85.37%and60.98%of the total patients had met the goal of its guideline,which was significantly higher than at thebeginning.Otherwise,the control of FPG was not optimistic, the mean value of FPG was7.82mmol/L,and only40.74%of the patients met the goal of its guideline, inaddition,there was no improvement at follow-up, and2hPG and HbAlc were thesame.Then,the control of the office blood pressure was perfect,but the home bloodpressure and the24-hour ambulatory blood pressure were poorly controlled, thepercentages of their SBP which met its guideline were79.35%,40.63%and42.31%,while, the percentages of their DBPwere98.37%,55.21%,65.30%. Finally, atthe beginning, the prescription rate of antiplatelet agents, statins, beta-blockers andangiotensin-converting enzyme inhibitorsor angiotensin receptor blockers was81.71%,84.15%,59.93%,49.39%and41.46%of the patientsused the recommended drugcombination,which was the same with that at follow-up.Conclusions: In Fujian Province, dyslipidemia is bettercontrolled rather than anyother risk factors of coronary heart disease,and the control of heart rate is poor.In therecommended pharmacotherapy for secondary prevention of coronary heart disease,theprescriptions of antiplatelet agents, statinsand angiotensin-converting enzymeinhibitorsor angiotensin receptor blockers is close toother domestic and internationalresearches,but the prescriptions of beta-blockers is not optimistic. To medical personnel,health education of coronary heart disease risk factors, strengthening secondaryprevention and minimizing the gap between clinical practice and evidence-basedguidelines are important.