Variability among cardiologists in the management of patients under secondary prevention of ischemic heart disease.

Objective: To compare the management of patients with ischemic heart disease being followed up in a general cardiology outpatient clinic with that of patients being followed up in an outpatient clinic specific for ischemic heart disease, emphasizing the lipid profile and the pharmacological treatment prescribed.

Methods: Data were collected from the medical records of 52 patients consecutively treated in the outpatient clinic for ischemic heart disease (group I) and of 43 patients treated in the general cardiology outpatient clinic (group II), the anatomical diagnosis of ischemic heart disease being the basic condition for their inclusion in the study. The criteria for dyslipidemia were as follows: total cholesterol > or = 200 mg/dL or LDL-cholesterol > 100 mg/dL, or both, in patients using or not lipid-lowering drugs, and the use of lipid-lowering drugs, even when the total cholesterol or LDL-cholesterol levels were < 200 mg/dL and 100 mg/dL, respectively, or both. The Fisher exact test was used for comparing the variables, and a 2-tailed p < 0.05 was accepted as significant.

Results: Demographic characteristics, risk factors for ischemic heart disease, prevalence of previous myocardial infarction, and previous revascularization procedures showed no significant differences between the patients in groups I and II. In group I, 98% of the patients received aspirin, while, in group II, 83% of the patients received that drug (p = 0.02). In regard to the use of lipid-lowering drugs, the prevalences were 60% in group I and 19% in group II (p = 0.001). The lipid profile examination was requested for 98% of group I individuals and 79% of group II individuals (p = 0.003).

Conclusion: In regard to new medical evidence, mainly prescription of aspirin and lipid-lowering drugs, the management was more reliable in the outpatient clinic specifically aimed at treating ischemic heart disease.