Prescrição de terapias baseadas em evidências para pacientes de alto risco cardiovascular: estudo REACT

• Autor(a) principal: Berwanger, Otávio [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Mattos, Luiz Alberto Piva e, Martin, José Fernando Vilela, Lopes, Renato Delascio [UNIFESP], Figueiredo, Estevão Lanna, Magnoni, Daniel, Precoma, Dalton Bertolim, Machado, Carlos Alberto, Guimarães, Jorge Ilha, Andrade, Jadelson Pinheiro de
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.5935/abc.20130062; http://repositorio.unifesp.br/handle/11600/7636
• topic: Cardiovascular Diseases; mortality; Review; Cross-Sectional Studies; Risk Factors; Drug Prescriptions; Randomized Controlled Trials as Topic; Doenças Cardiovasculares; mortalidade; Revisão; Estudos Transversais; Fatores de Risco; Prescrição de Medicamentos; Ensaios Clínicos Controlados Aleatórios como Assunto

BACKGROUND: Data on outpatient care provided to patients at high cardiovascular risk in Brazil are insufficient. OBJECTIVE: To describe the profile and document the clinical practice of outpatient care in patients at high cardiovascular risk in Brazil, regarding the prescription of evidence-based therapies. METHODS: Prospective registry that documented the ambulatory clinical practice in individuals at high cardiovascular risk, which was defined as the presence of the following factors: coronary artery disease, cerebrovascular and peripheral vascular diseases, diabetes, or those with at least three of the following factors: hypertension, smoking, dyslipidemia, age > 70 years, family history of coronary artery disease, chronic kidney disease or asymptomatic carotid artery disease. Basal characteristics were assessed and the rate of prescription of pharmacological and non-pharmacological interventions was analyzed. RESULTS: A total of 2364 consecutive patients were included, of which 52.2% were males, with a mean age of 66.0 years (± 10.1). Of these, 78.3% used antiplatelet agents, 77.0% used statins and of patients with a history of myocardial infarction, 58.0% received beta-blockers. Concomitant use of these three classes of drugs was 34%; 50.9% of hypertensive, 67% of diabetic and 25.7% of dyslipidemic patients did not achieve the goals recommended by guidelines. The main predictors of prescription therapies with proven benefit were centers with a cardiologist and history of coronary artery disease. CONCLUSION: This national and representative registry identified important gaps in the incorporation of therapies with proven benefit, offering a realistic outlook of patients at high cardiovascular risk.