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Erschienen in: European Journal of Epidemiology 3/2019

23.10.2018 | CARDIOVASCULAR DISEASE

Incidence of cardiovascular events in patients with stabilized coronary heart disease: the EUROASPIRE IV follow-up study

verfasst von: Dirk De Bacquer, Delphine De Smedt, Kornelia Kotseva, Catriona Jennings, David Wood, Lars Rydén, Viveca Gyberg, Bahira Shahim, Philippe Amouyel, Jan Bruthans, Almudena Castro Conde, Renata Cífková, Jaap W. Deckers, Johan De Sutter, Mirza Dilic, Maryna Dolzhenko, Andrejs Erglis, Zlatko Fras, Dan Gaita, Nina Gotcheva, John Goudevenos, Peter Heuschmann, Aleksandras Laucevicius, Seppo Lehto, Dragan Lovic, Davor Miličić, David Moore, Evagoras Nicolaides, Raphael Oganov, Andrzej Pajak, Nana Pogosova, Zeljko Reiner, Martin Stagmo, Stefan Störk, Lale Tokgözoğlu, Dusko Vulic, Martin Wagner, Guy De Backer, On behalf of the EUROASPIRE Investigators

Erschienen in: European Journal of Epidemiology | Ausgabe 3/2019

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Abstract

The EUROASPIRE surveys (EUROpean Action on Secondary Prevention through Intervention to Reduce Events) demonstrated that most European coronary patients fail to achieve lifestyle, risk factor and therapeutic targets. Here we report on the 2-year incidence of hard cardiovascular (CV) endpoints in the EUROASPIRE IV cohort. EUROASPIRE IV (2012–2013) was a large cross-sectional study undertaken at 78 centres from selected geographical areas in 24 European countries. Patients were interviewed and examined at least 6 months following hospitalization for a coronary event or procedure. Fatal and non-fatal CV events occurring at least 1 year after this baseline screening were registered. The primary outcome in our analyses was the incidence of CV death or non-fatal myocardial infarction, stroke or heart failure. Cox regression models, stratified for country, were fitted to relate baseline characteristics to outcome. Our analyses included 7471 predominantly male patients. Overall, 222 deaths were registered of whom 58% were cardiovascular. The incidence of the primary outcome was 42 per 1000 person-years. Comorbidities were strongly and significantly associated with the primary outcome (multivariately adjusted hazard ratio HR, 95% confidence interval): severe chronic kidney disease (HR 2.36, 1.44–3.85), uncontrolled diabetes (HR 1.89, 1.50–2.38), resting heart rate ≥ 75 bpm (HR 1.74, 1.30–2.32), history of stroke (HR 1.70, 1.27–2.29), peripheral artery disease (HR 1.48, 1.09–2.01), history of heart failure (HR 1.47, 1.08–2.01) and history of acute myocardial infarction (HR 1.27, 1.05–1.53). Low education and feelings of depression were significantly associated with increased risk. Lifestyle factors such as persistent smoking, insufficient physical activity and central obesity were not significantly related to adverse outcome. Blood pressure and LDL-C levels appeared to be unrelated to cardiovascular events irrespective of treatment. In patients with stabilized CHD, comorbid conditions that may reflect the ubiquitous nature of atherosclerosis, dominate lifestyle-related and other modifiable risk factors in terms of prognosis, at least over a 2-year follow-up period.
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Metadaten
Titel
Incidence of cardiovascular events in patients with stabilized coronary heart disease: the EUROASPIRE IV follow-up study
verfasst von
Dirk De Bacquer
Delphine De Smedt
Kornelia Kotseva
Catriona Jennings
David Wood
Lars Rydén
Viveca Gyberg
Bahira Shahim
Philippe Amouyel
Jan Bruthans
Almudena Castro Conde
Renata Cífková
Jaap W. Deckers
Johan De Sutter
Mirza Dilic
Maryna Dolzhenko
Andrejs Erglis
Zlatko Fras
Dan Gaita
Nina Gotcheva
John Goudevenos
Peter Heuschmann
Aleksandras Laucevicius
Seppo Lehto
Dragan Lovic
Davor Miličić
David Moore
Evagoras Nicolaides
Raphael Oganov
Andrzej Pajak
Nana Pogosova
Zeljko Reiner
Martin Stagmo
Stefan Störk
Lale Tokgözoğlu
Dusko Vulic
Martin Wagner
Guy De Backer
On behalf of the EUROASPIRE Investigators
Publikationsdatum
23.10.2018
Verlag
Springer Netherlands
Erschienen in
European Journal of Epidemiology / Ausgabe 3/2019
Print ISSN: 0393-2990
Elektronische ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-018-0454-0

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