A first heart attack followed by another? One unique project teaches patients how to prevent this
Almost 23,000 people in the Czech Republic suffer from acute myocardial infarction every year. Those who get to a specialized cardiac centre in time stand a good chance of survival. However, one-third of the patients soon return to hospital with another heart attack. The mortality rate in such patients is much higher, up to three times. Strict observation of a healthy lifestyle and having knowledge of the risk factors of ischemic heart disease decreases the probability of a second infarction. This is confirmed by the results of the Life after Infarction training programme, in which the International Clinical Research Centre at St. Anne’s University Hospital in Brno (FNUSA-ICRC) participated. The findings were awarded at the World Congress of Cardiology in Dubai, among other things.
The treatment of infarction has improved so much over the past 25 years in the Czech Republic that a patient can be released into home care after just several days of hospitalization; however, a large number of these patients suffers a second or even third infarction, for which the risk is much higher. St. Anne’s University Hospital in Brno, together with cardiac centres in Ostrava, Olomouc, Zlín, Jihlava and Brno, took part in the international project entitled “Life after Myocardial Infarction”. Besides Czech cardiac centres, the programme involved centres from Spain, Portugal and Greece.
“If we provide patients with sufficient information about how to look after themselves after suffering a heart attack, the probability of repeated hospitalization decreases by 30%,” says MUDr. Ota Hlinomaz, a physician from the 1st Department of Internal Cardio-angiology and the head of the Acute Coronary Syndromes research team at FNUSA-ICRC. “The objective of the Life after Myocardial Infarction programme was to map deficiencies in the existing secondary prevention programme, create quality educational materials, both for the patients and for health care professionals, and enable patients to better understand their risk factors.”
Patients were advised of their risk factors and then signed a Contract for Life after Infarction in which they agreed to implement specific lifestyle changes. It contains a resolution to quit smoking, adjust their diet and exercise. Similar changes can help regulate cholesterol levels and blood pressure and lower the risk of another infarction.
Subsequently, researchers assessed how the informed patients changed their lifestyles. “Standardized timely training provided by a nurse resulted in a subsequent decline in patient cholesterol levels, especially LDL – cholesterol*. Patients also substantially reduced smoking. The annual number of cardiovascular events and overall mortality in the informed group of patients significantly decreased,” says Ota Hlinomaz.
The conclusions reached in the Life after Myocardial Infarction programme show that educating patients and increasing their awareness of the risk factors of myocardial infraction should become an integral part of their treatment. “The pilot stage of the programme was very successful, which is documented by the fact that we were invited to present the results at the World Congress of Cardiology in Dubai in December last year,” says programme manager MUDr. Zuzana Kaifoszová from HELIS Partners Consulting.
“We believe that targeted patient education will become an integral part of timely comprehensive recovery in patients who have suffered from a myocardial infarction. This year, we will also launch a training programme for patients after suffering a heart attack in Poděbrady,” adds Dr. Kaifoszová
* – LDL cholesterol causes excessive cholesterol build-up in the walls of blood vessels.