To maintain a proper follow-up of the patients with coronary artery disease is as nearly important as medications Sait Demirkol a , Mustafa Cakar b , Sevket Balta a, ⁎, Murat Unlu a , Seyit Ahmet Ay b , Murat Karaman b a Gulhane Medical Academy, Department of Cardiology, Ankara, Turkey b Gulhane Medical Academy, Department of Internal Medicine, Ankara, Turkey article info Article history: Received 3 November 2012 Accepted 11 November 2012 Available online 30 November 2012 Keywords: Secondary prevention Coronary Proper follow-up Dear Editor, We read with great interest the article “Secondary prevention in coronary artery disease: Achieved goals and possibilities for improve- ments” written by Berglind Libungan et al. [1]. The authors concluded that secondary prevention is important in order to fight further progression of atherosclerotic disease and reduce mortality in coronary artery disease and wrote that the majority of patients do not achieve the guideline target goals and further intensification of therapy is indicated in order to reach them. We thank the authors for the contribution of their present study which is successfully designed and documented. We believe that these findings will enlighten further studies about secondary prevention in coronary artery disease patients. The authors mentioned that they finally evaluated 27% of patients initially recruited in the study. A lacking point of generally all prospective trials is in terms of patient follow up and maintaining the comeback to controls. Sometimes this is because of patient noncompliance, unwill- ingness to participate in a control visit or study, having the control examination done in another healthcare center, or sometimes obligatory causes like death. The notably low back to control examination rate in this study is a lacking point too, and we think that the results of the study would be stronger if more of the patients would come to follow up, though they already have seen enough number of patients in the control visit. In addition, although the relationship between physical activity and cardiac risk factors in secondary prevention of patients with coronary artery disease has been known [2,3], the authors did not discuss the relationship between physical activity and cardiac risks. Secondary prevention in coronary artery disease is important in terms of decreasing the post-accident complications or events that may develop in time [4]. The follow up of the patients should be made properly in order to achieve the target goals [5]. To maintain patient compliance, to describe to the patients their medication in detail, to explain to the patient all of the responsible factors leading to disease complications, and to convince them to come to control visits are very important aspects of the condition. We think that a reasonable follow up of the patients is nearly as important as treatment and mandatory medications. References [1] Libungan B, Stensdotter L, Hjalmarson A, et al. Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements. Int J Cardiol Nov 1 2012;161(1):18–24. [2] Williams MA, Haskell WL, Ades PA, et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation Jul 31 2007;116(5):572–84. [3] Bäck M, Cider A, Gillström J, et al. Physical activity in relation to cardiac risk markers in secondary prevention of coronary artery disease. Int J Cardiol 2012 Oct 4, doi: 10.1016/ j.ijcard.2012.09.117 . [4] Gupta R. Secondary prevention of coronary artery disease in urban Indian primary care. Int J Cardiol Jun 26 2009;135(2):184–6. [5] Griffo R, Ambrosetti M, Tramarin R, et al. Effective secondary prevention through cardiac rehabilitation after coronary revascularization and predictors of poor adherence to lifestyle modification and medication. Results of the ICAROS survey. Int J Cardiol doi:10.1016/j.ijcard.2012.04.069. 0167-5273/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijcard.2012.11.106 ⁎ Corresponding author at: Department of Cardiology, Gulhane School of Medicine, Tevfik Saglam St., 06018 Etlik-Ankara, Turkey. Tel.: +90 312 3044281; fax: +90 312 3044250. E-mail address: drsevketb@gmail.com (S. Balta). 2372 Letters to the Editor