Background: The EUROASPIRE IV survey was a cross-sectional study undertaken in coronary patients in 78 centres from 24 European countries.
Purpose: To describe the determinants of participation and achievement of risk factor targets in coronary patients attending a cardiovascular rehabilitation programme (CRP).
Methods: Consecutive patients aged <80 years with acute coronary syndromes and/or revascularization procedures were identified from hospital records and interviewed and examined at least 6 months after their recruiting event.
Results: A total of 7998 patients (24% females) were interviewed on average 16 months after having experienced a cardiac event. Overall, 51% of patients were advised to participate in a CRP and 81% of them attended at least half of the sessions; being only 41% of the whole study population. Older patients, women, those at low socio-economic status or enrolled with percutaneous coronary intervention (PCI) and unstable angina, as well as those with a previous history of coronary disease, heart failure, hypertension or dysglycaemia received less advice to follow a CRP. Patients recruited after CABG and AMI were more likely to get such advice. People smoking in the month prior to the recruiting event did participate much less in a CRP, if advised. The proportions of patients achieving lifestyle targets were higher in the CRP group as compared to the non-CRP group: stopping smoking (57% vs 47%, p<0.0001), recommended physical activity levels (47% vs 38%, p<0.0001) and BMI <30 kg/m2 (65% vs 61%, p=0.0007). However, there were no differences in terms of management of blood pressure, lipids and controlled HbA1c levels in patients with diabetes.
Conclusions: Just over 40% of coronary patients reported attending a CRP. Although the control of smoking, obesity and physical activity was better in those attended a CRP there were no differences in terms of blood pressure, lipids and glucose management. There is an urgent need of comprehensive, multidisciplinary prevention programmes addressing all aspects of the lifestyle, other risk factors and therapeutic management for all patients with coronary or other atherosclerotic disease.