Fernando Alfonso1, Karlen Adamyan2, Jean-Yves Artigou3, Michael Aschermann4, Michael Boehm5, Alfonso Buendia6, Pao-Hsien Chu7, Ariel Cohen8, Livio Dei Cas9, Mirza Dilic10, Anton Doubell11, Dario Echeverri12, Nuray Enç13, Ignacio Ferreira-González14, Krzysztof J. Filipiak15, Andreas Flammer16, Eckart Fleck17, Plamen Gatzov18, Carmen Ginghina19, Lino Goncalves20, Habib Haouala21, Mahmoud Hassanein22, Gerd Heusch23, Kurt Huber24, Ivan Hulín25, Mario Ivanusa26, Rungroj Krittayaphong27, Chu-Pak Lau28, Germanas Marinskis29, François Mach30, Luiz Felipe Moreira31, Tuomo Nieminen32, Latifa Oukerraj33, Stefan Perings34, Luc Pierard35, Tatjana Potpara36, Walter Reyes-Caorsi37, Se-Joong Rim38, Olaf Rødevand39, Georges Saade40, Mikael Sander41, Evgeny Shlyakhto42, Bilgin Timuralp43, Dimitris Tousoulis44, Dilek Ural45, J. J. Piek46, Albert Varga47, Thomas F. Lüscher48 on behalf of the Editors’ Network European Society of Cardiology Task Force 1 Chairman Editors ́Network; 2 Editor in Chief Armenian Journal of Cardiology; 3 Editor in Chief Archives des maladies du cœur et des vaisseaux Pratique; 4 Editor in Chief Cor et Vasa; 5 Editor in Chief Clinical Research in Cardiology; 6 Editor in Chief Archivos de Cardiologia de Mexico; 7 Editor in Chief Acta Cardiologica Sinica; 8 Editor in Chief Archives of Cardiovascular Diseases; 9 Editor in Chief Journal of Cardiovascular Medicine; 10 Editor in Chief Medicinski Zurnal; 11 Editor in Chief SA Heart; 12 Editor in Chief Revista Colombiana de Cardiologia; 13 Editor in Chief Kardiyovaskuler Hemsirelik Dergisi; 14 Editor in Chief Revista Española de Cardiología; 15 Editor in Chief Kardiologia Polska; 16 Editor in Chief Cardiovascular Medecine; 17 Editor in Chief Cardio News; 18 Editor in Chief Bulgarian Journal of Cardiology; 19 Editor in Chief Romanian Journal of Cardiology; 20 Editor in Chief Revista Portuguesa de Cardiologia; 21 Editor in Chief Cardiologie Tunisienne; 22 Editor in Chief The Egyptian Heart Journal; 23 Editor in Chief Basic Research in Cardiology; 24 Editor in Chief Austrian Journal of Cardiology; 25 Editor in Chief Cardiology Letters; 26 Editor in Chief Cardiologia Croatica; 27 Editor in Chief Thai Heart Journal; 28 Editor in Chief Journal of the Hong Kong Colleage of Cardiology; 29 Editor in Chief Seminars in Cardiovascular Medicine; 30 Editor in Chief Cardiovascular Medecine; 31 Editor in Chief Arquivos Brasileiros de Cardiologia; 32 Editor in Chief Sydänääni (Heart Beat); 33 Editor in Chief La Revue Marocaine de Cardiologie; 34 Editor in Chief Der Kardiologie; 35 Editor in Chief Acta Cardiologica; 36 Editor in Chief Heart and Blood Vessels; 37 Editor in Chief Revista Uruguaya de Cardiologia; 38 Editor in Chief Korean Circulation Journal; 39 Editor in Chief Hjerteforum; 40 Editor in Chief Heart News; 41 Editor in Chief Cardiologisk Forum; 42 Editor in Chief Russian Journal of Cardiology; 43 Editor in Chief Anatolian Journal of Cardiology; 44 Editor in Chief Hellenic Journal of Cardiology; 45 Editor in Chief Archives of the Turkish Society of Cardiology; 46 Editor in Chief Netherlands Heart Journal; 47 Editor in Chief Cardiologia Hungarica; 48 Editor in Chief European Heart Journal

Aims To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe. Methods and results EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later. A total of 16,426 medical records were reviewed and 7998 patients (24.4% females) interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of those smoking at the time of the event were persistent smokers. Little or no physical activity was reported by 59.9%; 37.6% were obese (BMI ≥ 30 kg/m2) and 58.2% centrally obese (waist circumference ≥ 102 cm in men or ≥88 cm in women); 42.7% had blood pressure ≥ 140/90 mmHg (≥140/80 in people with diabetes); 80.5% had low-density lipoprotein cholesterol ≥ 1.8 mmol/l and 26.8% reported having diabetes. Cardioprotective medication was: anti-platelets 93.8%; beta-blockers 82.6%; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75.1%; and statins 85.7%. Of the patients 50.7% were advised to participate in a cardiac rehabilitation programme and 81.3% of those advised attended at least one-half of the sessions. Conclusion A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes. Risk factor control is inadequate despite high reported use of medications and there are large variations in secondary prevention practice between centres. Less than one-half of the coronary patients access cardiac prevention and rehabilitation programmes. All coronary and vascular patients require a modern preventive cardiology programme, appropriately adapted to medical and cultural settings in each country, to achieve healthier lifestyles, better risk factor control and adherence with cardioprotective medications.

Reperfusion therapy remains the most effective treatment for patients suffering from acute coronary syndrome. The start time of reperfusion therapy is an important factor, and has a positive influence in reducing the number of days of hospitalisation, occurrences of readmi ssion, risk of reinfarction, and both short and long-term mortality. Several models of reperfusion therapy are available: thrombolytic treatment (pre-hospital or in-hospital), primary percutaneous coronary intervention (primary PCI [pPCI]), or a combination of both. PPCI is the preferred treatment (and should be administered as early as possible) in centres with experienced teams, especially for patients in cardiogenic shock, or those with contraindicated fibrinolytic (TL) therapies. Many randomised clinical trials have shown that pPCI is superior to TL in reducing mortality, reinfarction, and stroke. Our aim is to describe the easiest and quickest way of establishing the primary PCI network in Bosnia and Herzegovina. It is possible, by combining the efforts of both entities of Bosnia and Herzegovina, to establish a functional and effective PCI network, particularly since Bosnia and Herzegovina has become a participant in the Stent for Life initiative.