Treatment uptake levels among the coronary heart disease patients at the university hospital

AMAÇ: Amaç bir üniversite hastanesinde koroner kalp hastalığı olan 35 yaş ve üzeri kişilerdeki risk etmenlerinin, uygulanan tedavi düzeylerinin belirlenmesidir. YÖNTEMLER: Tanımlayıcı tipteki araştırma Dokuz Eylül Üniversitesi Hastanesi'nde yapılmıştır. Geriye dönük taranan kayıtlara göre DEÜ Hastanesi'nde 1 Ocak- 31 Aralık 2008'de KKH ve koroner bypass tanılı hastalar çalışmanın olgularını oluşturmuştur. Toplam 392 hastaya ulaşılmıştır. Değişkenler başvuru öncesi hastalık ve risk öyküsü, ilaç kullanımı, hastanede uygulanan girişimler, taburcu olurken reçete edilen ilaçlardır. Veri sıklık dağılımları ve yüzdeler biçiminde sunulmuştur. BULGULAR: Hastaların üçte birinde diyabet, hiperlipidemi ya da sigara riski, %65.6'sında hipertansiyon bulunmaktadır. Anjinalı olguların %86.2'sine, akut MI'lıların %85.4'üne anjiyografi, anjinalı hastaların %30.9'una, akut MI'lıların %54.4'üne anjiyoplasti, anjinalıların %13.8'ine, akut MI'lıların %11.1'ine by-pass cerrahisi yapılmıştır. Hastaneden çıkışta anjinalı hastaların %68.8'ine beta bloker, %79.6'sına statin, %28.0'ına ACE inhibitörü, %88.2'sine aspirin; MI'lı hastaların %84.1'ine beta bloker, %89.7'sine statin, %60.7'sine ACE inhibitörü, %95.3'üne aspirin reçete edilmiştir. Kalp yetmezliğinde ilaçların reçete edilme oranları beta blokerde %54.0, statinde %39.7, ACE inhibitöründe %42.9, aspirinde %71.4'tür. SONUÇ: İlaçların reçete edilme oranları düşüktür. Toplumda KKH mortalitesinin azaltılmasında etkili tedavilerin reçete edilmesi ve kullanımı önemlidir. OBJECTIVE: Aim of the study was to determine the treatment uptake levels and risk factors among the coronary heart disease patients over 35 years old at the university hospital. METHODS: This descriptive study was conducted in the Dokuz Eylul University Hospital. Patients diagnosed with Coronary Heart Disease or coronary by-pass graphy between 1 January-31 December 2008 in DEU Hospital formed the study group based on the hospital records which was screened retrospectively. In total 392 patients files were screened. Variables used in the survey were; information about morbidity, risk factors and use of medications, procedures applied during hospitalization and the medications at discharge. Data were presented as frequencies and percentages. RESULTS: One third of the patients presented risk of diabetes, hyperlipidemia or smoking and 65.6% had hypertension. 86.2% of the patients with angina and 85.4% of acute MI patients had angiography procedure, 29.8% of angina patients and 54.4% of MI patients had angioplasty; 13.8% of angina patients and 11.1% of AMI patients had by-pass surgery. Prescribed medications at discharge among the angina patients were 68.8% for beta blocker, 79.6% Statin, 28.0% ACE inhibitor, 88.2% aspirin. Beta blockers were prescribed to 84.1%, Statin to 89.7%, ACE inhibitor to 60.7%, Aspirin to 95.3% of the AMI patients. Beta blocker was prescribed to 54.0%, statin to 39.7%, ACE inhibitor to 60.7%, Aspirin to 71.4% of the heart failure patients. CONCLUSION: The treatment uptake levels for most of the CHD groups at the hospital discharge are low. It is important to provide effective medications to all eligible CHD patients to reduce CHD mortality in the community

Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008.

BACKGROUND: Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008. METHODS: The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred. RESULTS: The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994-2008, whilst in women it was 2.8% between 1994-2000 and 6.7% between 2005-2008 (p < 0.05 for all periods).Stroke mortality declined between 1990-1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994-2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods). CONCLUSIONS: A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control