Post-myocardial infarction patients: a comparison of management by a physician and a cardiologist according to the REGATA register

Aim. To assess the quality of diagnostics and treatment of outpatients with a history of myocardial infarction (MI) according to REGATA register.

Material and methods. In 2012-2013, 481 patients with a MI history who sought help in ambulatory care clinic were included in the study. In 87,5% of cases, the reference visit was to a physician or cardiologist, in 12,5% — to other specialist. The median age was 72 [62; 78] years (men — 51,4% (n=247)). The median time of previous MI was 5 [2; 9] years before the inclusion date.

Results. A total of 23,5% of patients with previous MI had never visited a cardiologist before, 37% of patients visited a cardiologist in the last 12 months before being included in the registry. The use of diagnostic tests was insufficient, regardless of specialty of a doctor managing a patient. In patients managed by a cardiologist, electrocardiography, 24-hour Holter ECG monitoring, echocardiography, exercise tolerance test were much more often used. Cardiovascular agents were prescribed at the last visit to a physician and/or cardiologist in 91,9% of cases. Angiotensin converting enzyme inhibitors were used in 49,6% of patients, sartan medicines — 25,6%, beta-blockers — 57,7%, calcium channel antagonists — 21,7%, long-acting nitrates — 20,0%, statins — 45,1 %, antiplatelet agents — 67,3%. In patients who visited/not visited a cardiologist, the frequency of prescribing cardiovascular agents did not significantly differ, except for statins (50,0% vs 23,9%, respectively (p<0,0001)).

Conclusion. The results obtained indicate that quality of managing outpatients after MI is higher by cardiologists than by physicians. However, the use of diagnostic tests and cardiovascular agents is insufficient, regardless of specialty of a doctor managing a patient.

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