| Abstract [eng] |
Objective. To evaluate the quality of long-term treatment in patients after myocardial infarction according to the European Society of Cardiology guidelines, determine the prevalence of successfully modified cardiovascular risk factors and assess the association between psychological disorders, sociodemographic characteristics and achievement of treatment goals. Material and methods. This retrospective cohort study included patients treated at the Preventive Cardiology Department of Vilnius University Hospital Santaros Clinics between 2016 and 2023. Participants were part of an ongoing biomedical study “Assessment of Life and Treatment Quality in Patients After Myocardial Infarction”. Cardiovascular risk factors and discharge medications were evaluated during outpatient visits conducted no earlier than three months after myocardial infarction. Low-density lipoprotein cholesterol levels were measured during hospitalization, after 3 and 6 months, and at the most recent follow-up visit (between 1 and 5 years post-event). Patients completed a questionnaire on satisfaction with care and the adequacy of information provided. Psychological well-being was assessed using the Hospital Anxiety and Depression Scale. Results. A total of 439 patients participated in the study: 341 men (78 %) and 98 women (22 %), with a mean age of 58,3 ± 10 years. Physical inactivity was observed in 296 (67 %) patients, 191 (44 %) were overweight and 167 (38 %) were obese. Blood pressure targets were not achieved by 229 (52 %) participants. Active smoking was reported by 94 (22 %) and 108 (26 %) had quit. Smoking was more prevalent among men (p < 0,001) and individuals with lower educational attainment(p = 0,007). Median low-density lipoprotein cholesterol concentration decreased from 3,53 [2,86 – 4,18] mmol/l during hospitalization to 2 [1,59 – 2,53] mmol/l at 3 months, 1,89 [1,5 – 2,5] mmol/l at 6 months and 1,8 [1,42 – 2,43] mmol/l at the last visit. The target level of low-density lipoprotein cholesterol was reached by 43 % of patients treated between 2016 and 2019 (< 1,8 mmol/l) and by 33 % of those treated between 2019 and 2023 (< 1,4 mmol/l). Depression and anxiety symptoms were linked to lower achievement of low-density lipoprotein cholesterol target levels (p = 0,003) and greater severity was associated with higher concentrations (p = 0,018). No significant associations were found with other risk factors (p > 0,05). Most patients expressed satisfaction with the care and information received. Conclusion. Control of cardiovascular risk factors remains insufficient, with only one-third achieving target low-density lipoprotein cholesterol levels. Psychological symptoms were associated with poorer lipid control, while smoking was more prevalent among men and individuals with lower education. |
