Treatment goal attainment for secondary prevention in coronary patients with or without diabetes mellitus-Polish multicenter study POLASPIRE

Introduction: Cardiovascular disease is still a leading cause of death in Po-land and across Europe. The aim of this study was to assess the attainment of the main treatment goals for secondary cardiovascular prevention in cor-onary patients with or without diabetes mellitus (DM) in Poland.Material and methods: The study group included 1026 patients (65.5 +/- 9 y.o.; males: 72%) included at least 6 months after the index hospitalisation for myocardial infarction, unstable angina, elective percutaneous coronary in-tervention or coronary artery bypass surgery. The target and treatment goals were defined according to the 2016 European Society of Cardiology guide-lines on cardiovascular prevention.Results: Patients with DM (n = 332; 32%) were slightly older compared to non-diabetic (n = 694) individuals (67.2 +/- 7 vs. 64.6 +/- 9 years old; p < 0.0001). The DM goal was achieved in 196 patients (60%). The rate of primary (LDL: 51% vs. 35%; p < 0.0001) and secondary (non-HDL: 56% vs. 48%; p < 0.02) goal attainment was higher in DM(+) compared to DM(-) patients. The rate of target blood pressure was lower in DM(+) than in normoglycemic patients (52% vs. 61% at < 140/90 mm Hg, p < 0.01. As expected, goal achievement of normal weight (9.5% vs. 19%; p < 0.0001) and waist circumference (7% vs. 15%; p < 0.001) was lower in diabetic patients and the rate of regular physi-cal activity was similar (DM+ 12% vs. DM- 14%; p = ns). Finally, there was no difference in active smokers (DM+ 23% vs. DM- 22%; p = ns).Conclusions: Great majority of Polish patients in secondary prevention do not achieve treatment goals. Although lipid goals attainment is better in DM and the rate of smokers is similar, the management of all risk factors needs to be improved.

Automated summary

This study aimed to assess the achievement of main treatment goals in secondary cardiovascular prevention in Polish coronary patients. The results showed that the majority of patients did not reach the treatment goals, highlighting the need for improved management of all risk factors.