[The secondary prevention of ischaemic heart disease in Spain. A systematic review of observational studies]. / Prevención secundaria de la cardiopatía isquémica en España. Una aproximación desde los estudios observacionales.

OBJECTIVE: To describe the use of ischaemic heart disease (IHD) secondary prevention measures in the Spanish National Health System. DESIGN: Systematic review of observational studies with information on the use of preventive treatment and measures in the prevention of secondary IHD. SETTING: Primary care and specialised out-patient clinics. DATA SOURCES: Medline search and complementary searches of studies published between 1995 and 2004 with a description of the use secondary prevention measures on hospital discharge or in the follow up after discharge. SELECTION OF STUDIES: A total of 125 references were found after the MEDLINE search, 13 of which were selected after an independent review by 2 researchers. The complementary sources provided 9 more studies giving a total of 22. DATA EXTRACTION: One researcher extracted information on the characteristics of the study and the results variables, which were independently verified by a second evaluator. RESULTS. In the 22 studies found, a high level of variation was shown in the different treatment rates: anti-aggregants (at discharge, 72%-97.1%; follow-up, 46.4%-93.8%); beta-blockers (at discharge, 29%-68.3%; follow-up, 22.4%-59.0%); drugs with action on the renin-angiotensin system (at discharge, 16.2%-52.2%; follow-up, 6.1%-53.1%); lipid lowering drugs (at discharge, 6.7%-88.7%; follow-up, 24.5%-89.5%). The treatment rates showed a progressive improvement over time during the period studied. CONCLUSIONS: In the period 1994-2003 treatment rates in the secondary prevention of IHD have increased, although there is still much room for improvement.

Prevención secundaria de la cardiopatía isquémica en España. Una aproximación desde los estudios observacionales / The secondary prevention of ischaemic heart disease in Spain. A review of observational studies

Objetivo. Describir la utilización de medidas de prevención secundaria de la cardiopatía isquémica (CI) en el Sistema Nacional de Salud. Diseño. Revisión sistemática de estudios observacionales con información sobre uso de tratamientos y medidas preventivas en prevención secundaria de la CI. Emplazamiento. Atención extrahospitalaria, tanto primaria como especializada. Fuentes de datos. Búsqueda en MEDLINE y búsquedas complementarias de estudios publicados entre 1995 y 2004 con descripción del uso de medidas de prevención secundaria al alta hospitalaria o en el seguimiento tras el alta. Selección de estudios. Tras la búsqueda en MEDLINE se encontraron 125 referencias, de las que en la revisión independiente realizada por 2 investigadores se seleccionaron 13. Las fuentes complementarias aportaron 9 estudios hasta totalizar los 22 incluidos. Extracción de datos. Un investigador extrajo información sobre las características del estudio y las variables de resultado, que fue verificada independientemente por un segundo evaluador. Resultados. Se hallaron 22 estudios que muestran un alto grado de variabilidad en el uso de los diversos tratamientos índice: antiagregantes (al alta, 72-97,1%; seguimiento, 46,4-93,8%); bloqueadores beta (al alta, 29-68,3%; seguimiento, 22,4-59,0%); fármacos con acción sobre el sistema renina-angiotensina (al alta, 16,2-52,2%; seguimiento, 6,1-53,1%); hipolipemiantes (al alta, 6,7-88,7%; seguimiento, 24,5-89,5%). La evolución temporal de las cifras de tratamiento muestra una importante mejora en el período. Conclusiones. En el período 1994-2003 se ha incrementado la utilización de tratamientos índice en prevención secundaria, aunque aún queda un importante espacio de mejora

Objective. To describe the use of ischaemic heart disease (IHD) secondary prevention measures in the Spanish National Health System. Design. Systematic review of observational studies with information on the use of preventive treatment and measures in the prevention of secondary IHD. Setting. Primary care and specialised out-patient clinics. Data sources. Medline search and complementary searches of studies published between 1995 and 2004 with a description of the use secondary prevention measures on hospital discharge or in the follow up after discharge. Selection of studies. A total of 125 references were found after the MEDLINE search, 13 of which were selected after an independent review by 2 researchers. The complementary sources provided 9 more studies giving a total of 22. Data extraction. One researcher extracted information on the characteristics of the study and the results variables, which were independently verified by a second evaluator. Results. In the 22 studies found, a high level of variation was shown in the different treatment rates: anti-aggregants (at discharge, 72%-97.1%; follow-up, 46.4%-93.8%); beta-blockers (at discharge, 29%-68.3%; follow-up, 22.4%-59.0%); drugs with action on the renin-angiotensin system (at discharge, 16.2%-52.2%; follow-up, 6.1%-53.1%); lipid lowering drugs (at discharge, 6.7%-88.7%; follow-up, 24.5%-89.5%). The treatment rates showed a progressive improvement over time during the period studied. Conclusions. In the period 1994-2003 treatment rates in the secondary prevention of IHD have increased, although there is still much room for improvement