Are we meeting cardiovascular risk targets 3 years after acute coronary syndrome? An evaluation in West Auckland, New Zealand

Aim Several studies have shown poor achievement of cardiovascular targets in high risk patients. We measured these targets in patients with Acute Coronary Syndrome, three years after discharge from Waitakere Coronary Care Unit. Method A retrospective observational study was performed. All patients discharged in 2006 were included. Admission data was extracted from computerised records and patients were subsequently invited for appointment. Data collected included: blood pressure, lipid profile, BMI, smoking status, HbA1c, medications and contraindications, and lifestyle factors. Results were analysed and compared with national targets. Results Data was collected on 112 patients (22 patients died, 18 excluded and 18 lost to follow up). There was good compliance with blood pressure (mean 120/70 mmHg), smoking cessation and medication targets. However 22% of patients were not prescribed an ACE inhibitor at follow-up. Lipid profile improved, although only 52% of patients met LDL targets. There was no difference between admission and followup BMI. HbA1c had increased slightly, however this was not statistically significant. Eight diabetic patients (n=27) had an HbA1c of less than 7% at follow-up. Conclusion Although a small sample population, results showed mixed compliance but not as poor as previously reported. More effort is needed to attain LDL, HbA1c and BMI targets, and ensure ACE inhibitor initiation.