{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:27:20Z","timestamp":1774621640696,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Patients with prior acute myocardial infarction (AMI) generally show low rates of achieving secondary prevention targets. Here we evaluated adherence to guideline-recommended secondary prevention strategies after AMI in Saudi Arabia. This ambispective multicenter cohort study included consecutive patients seen for follow-up visits 6\u201324 months after hospitalization for AMI. A standardized questionnaire was used to evaluate control of blood pressure (&lt;130\/80 mmHg), HbA1c (&lt;7%), LDL-C (&lt;1.4 mmol\/L), lipoprotein(a) (&lt;50 mg\/dL), body mass index (18.5\u201324.9 kg\/m2), physical activity targets, smoking habits, guideline-directed medical therapy (GDMT), and referral to cardiac rehabilitation. Among 108 AMI patients (mean age 58.4 \u00b1 10.9 years; 80.6% male; 76.9% Saudi nationals), 53.7% had uncontrolled blood pressure, ~40% uncontrolled glucose, and 67% above-target LDL-C levels. Most participants were overweight (40.7%) or obese (37%), and 28.7% achieved the physical activity targets. One-third of patients were not receiving all GDMT, 15.7% were current smokers, and 25% had been referred to cardiac rehabilitation. No patient met all guideline-recommended secondary prevention targets. This pilot study highlights gaps in secondary prevention among AMI survivors. Upcoming study phases will aim for national representation and help identify key clinical and demographic drivers to improve secondary prevention efforts across Saudi Arabia.<\/jats:p>","DOI":"10.3390\/jcdd13020100","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T08:58:21Z","timestamp":1771837101000},"page":"100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Saudi Secondary Prevention Survey Study in Patients with Prior Acute Myocardial Infarction (4S Registry): Study Design and Pilot Phase Results"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-5690","authenticated-orcid":false,"given":"Rakan","family":"Alhabib","sequence":"first","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naji","family":"Kholaif","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Heart Centre, King Faisal Specialist Hospital & Research Center, Riyadh 12713, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0764-463X","authenticated-orcid":false,"given":"Abdulrahman","family":"Alnwiji","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3433-4458","authenticated-orcid":false,"given":"Fayez","family":"Al Zubair","sequence":"additional","affiliation":[{"name":"Heart Health Center, King Saud Medical City, Riyadh First Health Cluster, Riyadh 12746, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Almir","sequence":"additional","affiliation":[{"name":"Heart Health Center, King Saud Medical City, Riyadh First Health Cluster, Riyadh 12746, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Alzoman","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9632-8403","authenticated-orcid":false,"given":"Abdulmalik","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha","family":"Alsharkawy","sequence":"additional","affiliation":[{"name":"King Salman Hospital, Riyadh 12769, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Albahar","sequence":"additional","affiliation":[{"name":"Qatif Central Hospital, Eastern Health Cluster Ministry of Health, Qatif 32253, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Alhabib","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4184","DOI":"10.1093\/eurheartj\/ehae558","article-title":"Variation in secondary prevention of coronary heart disease: The INTERASPIRE study","volume":"45","author":"McEvoy","year":"2024","journal-title":"Eur. 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