Coverage of preventive counseling on cardiovascular risk factors in patients after myocardial infarction: data from a multicenter study

Aim. To assess the coverage of preventive counseling on the main modifiable cardiovascular risk factors (RFs) in patients after myocardial infarction (MI) and to identify factors associated with increased counseling activity within a year after the coronary event.

Material and methods. The study included 1107 patients with MI aged 35-75 years using a special randomization approach. After 6 months, 889 people were interviewed, and after 12 months — 703 people. At the hospital stage, the smoking status and alcohol consumption were clarified using the Cut down, Annoyed, Guilty, Eye-opener (CAGE) questionnaire. After 6 and 12 months, we clarified whether preventive counseling on the main cardiovascular RFs had been carried out. Social status, changes in life history and disease were also clarified to identify factors associated with receiving preventive counseling.

Results. Six and twelve months after MI, preventive counseling on smoking cessation was carried out in 63,8 and 58,4% of smoking patients, respectively; on alcohol cessation — in 16,5 and 14,9%. Patients with obesity (odds ratio (OR) 0,7; confidence interval (CI): 0,48-1,0; p=0,053) and type 2 diabetes (OR 0,49; CI: 0,29-0,82; p=0,008) received counseling on smoking cessation significantly less frequently. Smoking patients (OR 2,87; CI: 1,79-4,66; p<0,001) and those with left ventricular ejection fraction <50% (OR 1,6; CI: 1,01-2,56; p=0,048) received counseling on alcohol cessation more frequently. After 6 and 12 months, 71,5 and 71,6% of patients were consulted on dietary issues, while 56,8 and 31,6% of patients on physical activity, respectively. On dietary issues, obese patients received consultations significantly more often (OR 1,51; CI: 1,02-2,25; p=0,04). Patients observed by a cardiologist more often received consultations on healthy eating (OR 2,1; CI: 1,423,12; p<0,001) and physical activity (OR 2,0; CI: 1,35-2,97; p<0,001).

Conclusion. The study results revealed a deficit in preventive counseling on the main modifiable cardiovascular risk factors and their complications.

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