Associates' Presentations
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Secondary Prevention Of Coronary Artery Disease At A Community Multi-Specialty Medical Center

Jonathan A. Zlabek, M.D., Gundersen Lutheran Medical Foundation, La Crosse, WI

Background: There is convincing evidence in the literature that the secondary prevention of coronary artery disease is effective in decreasing morbidity and mortality. However, numerous studies indicate that patients are sub-optimally managed.

Purpose: To assess how well patients at a community multi-specialty medical center are meeting coronary artery disease secondary prevention guidelines.

Methods: By retrospective database review, patients hospitalized in a one year period at our institution for myocardial infarction, angioplasty, or coronary artery bypass grafting were identified. Of these patients, those who had their primary follow-up for coronary artery disease at the above-mentioned medical center were selected. Three hundred forty-eight patients were identified. The following data were collected from the last clinic visit and the last LDL cholesterol obtained in the year after hospitalization: smoking status, aspirin use, beta-blocker use, blood pressure, and LDL cholesterol.

Results: Eighty-five percent of patients were nonsmokers. Forty-seven percent of patients who previously smoked had stopped. Ninety-three percent of patients without contraindications were taking aspirin. Eighty-eight percent of patients without contraindications were taking beta-blockers after myocardial infarction. Sixty-six percent of patients had blood pressures less than or equal to 140/90. Thirty-six percent of patients had LDL cholesterol levels less than or equal to 100.

Conclusions: Although there is much room for improvement, this institution is doing as well as or better than other reports in the literature. The area in need of most improvement is the lowering of LDL cholesterol.

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