Treating cardiovascular risk factors following acute myocardial infarction

Aims: To assess the treatment of cardiovascular risk factors six or 12 months following a first episode of acute myocardial infarction. Method: We enrolled 307 patients who were 70 years old or less when the had their first acute myocardial infarction and who had been exonerated from co-payments for their long-term illness between January 1, 2001 and March 31, 2001 or between June 1, 2001 and August 31, 2001 in the Nord/Pas-de-Calais region of France. Data was gathered by the French healthfund’s salaried physician-advisors during the course of a clinical examination. Results: Drug prescriptions were not always optimal. 28 % of the patients with an alteration in left ventricular function were not receiving an angiotensin converting enzyme inhibitor. 26 % of the patients who had an LDL cholesterol level greater than 1.3 g/L were not being treated with a statin. Almost one-half the patients (48 %) did not have wellcontrolled arterial blood pressure. Risk factors were insufficiently corrected. Nearly 80 % of the patients were overweight with a body mass index equal to or greater than 25. One-third of smokers were still smoking. Cardiac rehabilitation, which encourages patients to stop smoking and helps in secondary prevention, was not prescribed in 37.5 % of the cases. Conclusion: We decided to undertake actions aimed at sensitizing practitioners to the accepted practice guidelines in conjunction with other regional health programs targeting both patients and healthcare professionals. A collegial discussion concerning available care, cardiovascular rehabilitation and treatment networks between the healthfund and all the players in healthcare is needed.