A pilot Croatian survey of risk factor (CRO-SURF) management in patients with cardiovascular disease [CRO-Surf: Hrvatski pilot-projekt ispitivanja čimbenika rizika u bolesnika s kardiovaskularnim bolestima]

Pećin, Ivan and Miličić, Davor and Jurin, Hrvoje and Reiner, Željko (2012) A pilot Croatian survey of risk factor (CRO-SURF) management in patients with cardiovascular disease [CRO-Surf: Hrvatski pilot-projekt ispitivanja čimbenika rizika u bolesnika s kardiovaskularnim bolestima]. Collegium Antropologicum, 36 (2). pp. 369-373. ISSN 0350-6134

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Abstract

A pilot survey was performed to determine the presence of known risk factors for cardiovascular disease in Croatian patients with diagnosed coronary heart disease (CHD) using a new questionnaire. The idea was to test this new and very simple questionnaire but also to compare the data collected in this pilot survey with the results of the last Croatian national survey (TASPIC-CRO V) and so to obtain the information whether secondary prevention has improved between 2003 and 2010. 122 patients with established CHD (88 men, 34 women, mean age 66.3 years) treated in Zagreb University Hospital Center were included. Data collection was based on filling the SURF questionnaire right after the clinical exam or later using review of medical records. Patients were hospitalized because of CABG (1%), PCI (8%), ACS (35%) or chronic stable angina (56%). The history of arterial hypertension had 95%patients (however, on admission mean systolic pressure was 130.1 mmHg, diastolic 76.8 mmHg), 90% had dyslipidaemia (total cholesterol <4.5 mmol/L had 43%; <4.0 mmol/L 33%; LDL-cholesterol <2.5 mmol/L 49%; <2.0 mmol/L 32%; HDL>1.2 mmol/L (women) or >1.0 mmol/L (men) had 67%), 25% had diabetes which was poorly regulated (mean HbA1c 8.2%), 18% were active smokers. After discharge only 24% performed cardiac rehabilitation. Mean body mass index of the patients was 28.3 kg/m2 (32% were obese, 72% overweight). Compared to TASPIC-CRO V there was lower usage of aspirin than recommended on discharge. This was also true for statin therapy. More patients were taking beta blockers, calcium antagonists and diuretics than 7 years ago. This pilot survey showed that CRO-SURF questionnaire is short, quick, effective and simple to use. It is a good and cost effective tool to collect data on CVD risk factors and their management. The results obtained by using it indicate that there is still a high prevalence of modifiable risk factors in Croatian patients with CHD.

Abstract in Croatian

Ovaj je pilot projekt proveden kako bi se istražila prisutnost čimbenika rizika za kardiovaskularne bolesti u hrvatskih bolesnika s dijagnosticiranom koronarnom srčanom bolesti (KBS) koristeći novi upitnik. Cilj je bio isprobati ovaj novi i vrlo jednostavan za uporabu upitnik te dobivene rezultate iz ovog pilot projekta usporediti s rezultatima posljednjeg istraživanja na nacionalnoj razini (TASPIC-CRO V), a sve s ciljem dobivanja informacije da li se sekundarna prevencija poboljšala u razdoblju od 2003. do 2010. Ukupno 122 ispitanika s definiranom KBS uključeno je u ovaj pilot- projekt (88 muškaraca, 34 žena, srednje dobi 66,3 godina) liječenih pri Kliničkom bolničkom centru Zagreb-Rebro, Zagreb, Hrvatska. Podaci su bazirani na ispunjavanju SURF upitnika odmah nakon kliničkog pregleda. 122 bolesnika hospitalizirano je zbog CABG (1%), PCI (8%), ACS (35%) ili kronične stabilne angine (56%). Anamnezu arterijske hipertenzije imalo je 95% ispitanika (ali prilikom primitka u bolnicu srednji sistolički arterijski tlak bio je 130,1 mmHg, dijastolički 76,8 mmHg), 90% ispitanika imalo je dislipidemiju (ukupni kolesterol <4,5 mmol/L imalo je 43%; <4,0 mmol/L 33%; LDL-kolesterol <2,5 mmol/L 49%; <2,0 mmol/L 32%; HDL>1.2 mmol/L (žene) ili >1.0 mmol/L (muškarci) imalo je 67%), 25% šećernu bolest koja je bila loše regulirana (srednji HbA1c 8,2%), 18% je bilo aktivnih pušača. Po otpustu iz bolnice samo 24% ispitanika provelo je propisanu kardiološku rehabilitaciju. Srednja vrijednost indeksa tjelesne mase bila je 28,3 kg/m2 (32% pretilo, 72% prekomjerno teško). U usporedbi s TASPIC-CRO V prati se trend manje uporabe acetil-salicilne kiseline. Ovaj trend prati se i vezano uz terapiju statinima. Više bolesnika uzima beta blokatore, antagoniste kalcijskih kanala i diuretika nego što je to bio slučaj prije 7 godina. Ovaj pilot-projekt s kratkim CRO-SURF upitnikom pokazuje kako je kratak, koristan i lak za uporabu u svakodnevnoj kliničkoj praksi. Pokazuje se kao dobar i isplativ alat za sakupljanje podataka vezanih uz čimbenike rizika za kardiovaskularne bolesti. Rezultati proizašli iz njega ukazuju na još uvijek visoku prevalenciju promjenjivih čimbenika rizika u hrvatskih bolesnika s KBS.

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