Cracovian program for secondary prevention of ischaemic heart disease.

Aim Hospitalisation due to ischaemic heart disease is a crucial moment for initiation of the secondary prevention of ischaemic heart disease. The aim of the study was to compare quality of medical care in the field of secondary prevention in Cracow cardiac departments between 1996–1997 and 1998–1999. Methods and results The study was carried out in six cardiac departments serving the area of the city and its province (1.2 mln inhabitants). Consecutive patients were identified according to the following categories: acute myocardial infarction, unstable angina, PCI or CABG. In total, we reviewed the hospital records of 1051 patients. The rate of available information on hypercholesterolemia, hypertension and diabetes prior to hospitalisation as well as the percentage of medical records with available information on blood pressure, total cholesterol, weight and height measurements increased significantly in 1998–1999 compared to 1996–1997. In addition, the frequency of prescribing antiplatelet and lipid-lowering drugs at discharge increased significantly in 1998–1999. The variation among participating departments in the rate of available information on risk factors prior to hospitalisation and on blood pressure and cholesterol measurements decreased in 1998–1999, as did the variation in the use of antiplatelets, ACE-inhibitors and lipid-lowering drugs. Conclusions The integration of ischaemic heart disease prevention into clinical practice in Cracow cardiac departments improved in 1998–1999 compared to 1996–1997. The biggest improvement could be observed in departments with the poorest quality of clinical care at baseline.