Analysis of secondary cardiac prevention in patients after myocardial infarction enrolled in the Coordinated Care Program in Patients after Myocardial Infarction (KOS-MI): a single-center experience.

INTRODUCTION

The Coordinated Care Program in Patients after Myocardial Infarction (KOS-MI) has substantially reduced mortality and heart failure-related hospitalizations through its comprehensive approach, including unlimited rehabilitation, cardiologist ambulatory care, complete revascularization, and electrotherapy in various long-term studies.

AIM: This study evaluated the outcomes and adherence to secondary preventive measures in patients who completed the KOS-MI Program 1 year and 3 years after myocardial infarction.

MATERIAL AND

METHODS

We conducted a retrospective registry involving 331 myocardial infarction patients who participated in the KOS-MI Program. Baseline and follow-up data included laboratory results (low density-lipoprotein (LDL) and glucose levels), echocardiography assessments, and drug compliance records.

RESULTS

At 12 months, 79.2% of patients (n = 262) had completed the program. Among them, 69.1% were men, and 46.2% presented with ST-elevation myocardial infarction. Complete revascularization was achieved in 55.7% of cases. Patients engaged in stationary or ambulatory rehabilitation constituted 56.1% and 43.9%, respectively. Notably, LDL levels significantly decreased from 129 mg/dl to 85.8 mg/dl (p < 0.001), with 19.1% of cases achieving the LDL goal of < 55 mg/dl. An HbA1c level below 7% was achieved by only 49% of diabetes patients. Left ventricular ejection fraction (LVEF) showed a statistically significant improvement (48.3% vs. 56.1%; p = 0.001). Drug adherence to dual antiplatelet therapy was 100%, while statin adherence was 99.6%.

CONCLUSIONS

The KOS-MI Program has significantly reduced LDL cholesterol levels and improved LVEF, especially in patients with the lowest initial LVEF. Future research should focus on optimizing LDL management and exploring long-term outcomes related to left ventricular function.