Literature DB >> 15772197

Improving secondary prevention in coronary bypass patients: closing the audit loop.

T N Martin1, R J Irving, M Sutherland, K Sutherland, P Bloomfield.   

Abstract

OBJECTIVES: To complete the audit loop assessing secondary preventative care of patients who had had coronary artery bypass graft (CABG) surgery.
DESIGN: Two separate surveys of 1000 patients who had had CABG at the regional centre between 1988 and 1997, selected in 1998 and 2001. A single page questionnaire was sent to the patient's general practitioner.
INTERVENTIONS: A list was sent to each general practice in Lothian, Scotland, of their patients on the CABG database and the results of the original survey. Lothian Health organised a project to contact and recall patients with cardiac disease in each practice. Sixty five (of 128) practices participated. MAIN OUTCOME MEASURES: Blood pressure, smoking status, serum cholesterol concentrations, and prescription of lipid lowering drugs and aspirin.
RESULTS: 918 questionnaires (92%) in the second survey were returned describing 875 patients: 151 (17%) patients smoked and 752 patients (86%) took aspirin. Mean (SD) systolic blood pressure was lower in the second survey (142.5 (19.2) mm Hg in the first survey v 139.4 (19.1) mm Hg, p < 0.005). In our first survey 34% of patients had cholesterol concentrations less than target (5.2 mmol/l). This increased from 12% of patients operated on in 1988 to 50% of patients operated on in 1997 (Spearman rank correlation 0.77, p < 0.01). In the second survey this proportion had risen to 65% and the correlation with year of operation was abolished.
CONCLUSIONS: By closing the audit loop, substantial improvements were shown in the management of risk factors in patients who have had coronary artery surgery in Lothian.

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Year:  2005        PMID: 15772197      PMCID: PMC1768852          DOI: 10.1136/hrt.2003.031989

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  9 in total

1.  Ten year audit of secondary prevention in coronary bypass patients.

Authors:  R J Irving; S H Oram; J Boyd; P Rutledge; F McRae; P Bloomfield
Journal:  BMJ       Date:  2000-07-01

2.  What do we gain from the sixth coronary heart disease drug?

Authors:  Rebecca N Warburton
Journal:  BMJ       Date:  2003-11-29

3.  Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. EUROASPIRE I and II Group. European Action on Secondary Prevention by Intervention to Reduce Events.

Authors: 
Journal:  Lancet       Date:  2001-03-31       Impact factor: 79.321

4.  Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries; principal results from EUROASPIRE II Euro Heart Survey Programme.

Authors: 
Journal:  Eur Heart J       Date:  2001-04       Impact factor: 29.983

5.  A British Cardiac Society survey of the potential for the secondary prevention of coronary disease: ASPIRE (Action on Secondary Prevention through Intervention to Reduce Events).

Authors:  T J Bowker; T C Clayton; J Ingham; N R McLennan; H L Hobson; S D Pyke; B Schofield; D A Wood
Journal:  Heart       Date:  1996-04       Impact factor: 5.994

6.  The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts.

Authors: 
Journal:  N Engl J Med       Date:  1997-01-16       Impact factor: 91.245

7.  The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators.

Authors:  F M Sacks; M A Pfeffer; L A Moye; J L Rouleau; J D Rutherford; T G Cole; L Brown; J W Warnica; J M Arnold; C C Wun; B R Davis; E Braunwald
Journal:  N Engl J Med       Date:  1996-10-03       Impact factor: 91.245

8.  Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)

Authors: 
Journal:  Lancet       Date:  1994-11-19       Impact factor: 79.321

9.  MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial.

Authors: 
Journal:  Lancet       Date:  2002-07-06       Impact factor: 79.321

  9 in total
  3 in total

Review 1.  Secondary revascularization after CABG surgery.

Authors:  Javier Escaned
Journal:  Nat Rev Cardiol       Date:  2012-07-10       Impact factor: 32.419

2.  Guidelines and risk factor management.

Authors:  P Primatesta
Journal:  Heart       Date:  2005-04       Impact factor: 5.994

3.  Effectiveness of nurse-delivered cardiovascular risk management in primary care: a randomised trial.

Authors:  Helene R Voogdt-Pruis; George H M I Beusmans; Anton P M Gorgels; Arnold D M Kester; Jan W Van Ree
Journal:  Br J Gen Pract       Date:  2010-01       Impact factor: 5.386

  3 in total

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