European guidelines on cardiovascular disease prevention in clinical practice. third joint task force of european and other societies on cardiovascular disease prevention in clinical practice

DeBacker, G; Ambrosioni, Ettore; Borch‐Johnsen, Knut

doi:10.1016/j.accreview.2003.12.022

Cited by 494 publications

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“…3,4,15 Established international guidelines emphasize the merits of aggressive risk reduction such as lifestyle modification along with antidiabetic, antihypertensive, or antiplatelet therapy for patients with established CV disease. 16,17 Besides optimal management of risk factors for atherothrombosis, antiplatelet agents are effective in reducing the risk of further ischemic events in patients with documented arterial disease. 18 In the Mexican population, despite the fact that symptomatic patients received fairly good CV risk 448 Clin.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Atherothrombosis and Its Treatment in Mexico: First‐Year Data of the REACH Registry

Gaxiola

Eng-Ceceña²,

Ortiz-Galván

et al. 2010

Clinical Cardiology

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Background: Atherothrombosis, a generalized and progressive process, is currently a major healthcare problem in Mexico. Methods: The worldwide Reduction of Atherothrombosis for Continued Health (REACH) registry aimed to evaluate risk factors for atherosclerosis, long-term cardiovascular (CV) event rates, and current management of either patients with established symptomatic atherosclerotic disease or asymptomatic subjects with multiple risk factors for atherothrombotic disease. One-year follow-up of the global REACH database was available for 64 977 outpatients. This report includes the Mexican subregistry wherein 62 internists, cardiologists, and neurologists evaluated baseline patient characteristics, risk factors, medications, and CV event rates as primary outcomes at 1-year follow-up. Results: Complete 1-year follow-up data were available for 837 Mexicans. We observed a high prevalence of diabetes (47.1%), hypertension (74.7%), and hypercholesterolemia (57.8%). Antiplatelet, antihypertensive and/or glucose-lowering agents, and lipid-lowering drugs were used in 87.6%, 84.1%, and 61% of patients, respectively. The all-cause mortality rate was 3.3%. The composite outcome CV death/myocardial infarction/stroke/hospitalization for atherothrombotic events was higher in the symptomatic group (14.6%) than in asymptomatic subjects with multiple risk factors (5.1%; P = 0.01), similar to Latin American results of the global REACH report. The highest CV event rate occurred among symptomatic atherothrombotic patients with 3 vascular disease locations (30.2%), followed by those with 2 (21.9%) and 1 location (13.4%; P = 0.0006). Conclusions: Prevalence of risk factors and CV event rates including hospitalization in Mexican atherothrombotic patients was high despite the current medication use, which suggests it is necessary to have more aggressive risk-factor management.The REACH registry is sponsored by sanofi-aventis, BristolMyers Squibb, and the Waksman Foundation of Japan (Tokyo, Japan). The REACH registry is endorsed by the World Heart Federation. A complete list of REACH investigators is accessible online at www.reachregistry.org. The REACH registry enforces a no-ghostwriting policy. This manuscript was written and edited by the authors, who take full responsibility for its content. The first draft was written by Dr. Efraín Gaxiola. All manuscripts in the REACH registry are prepared by independent authors who are not governed by the funding sponsors and are reviewed by an academic publications committee before submission. The funding sponsors have the opportunity to review manuscript submissions but do not have authority to change any aspect of a manuscript. Dr. Efraín Gaxiola has received research grants from sanofiaventis, speaker fees from Pfizer and Eli Lilly, and fees as an advisory board member from Abbott Labs and Pfizer. Dr. Luis Eng-Ceceña has received speaker fees from sanofi-aventis, Pfizer, Bayer, and AstraZeneca, and fees as advisory board member from Schering-Plough. Dr. Fernando Ortiz-Galván

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Section: Discussionmentioning

confidence: 99%

Assessment of Atherothrombosis and Its Treatment in Mexico: First‐Year Data of the REACH Registry

Gaxiola

Eng-Ceceña²,

Ortiz-Galván

et al. 2010

Clinical Cardiology

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“…In fact, drug interactions, adverse drug events, and prevention of polypharmacy could be very reasonable motivations to do so. Furthermore, we did not evaluate the influenza immunization practice -although strongly recommended as a long-term medical treatment for all patients with coronary artery disease [2][3][4] -as local general practitioners expect us to let this task to their competence.…”

Section: Discussionmentioning

confidence: 99%

“…We consecutively considered and analyzed the hospital discharge information of all patients hospitalized between March 1, 2007 [2][3][4][18][19][20]. This study allowed us to observe our steady-state situation of drug prescription, since it was performed without previous information campaign.…”

Section: Study Protocolmentioning

confidence: 99%

“…We then calculated the global prescription rate of secondary prophylaxis (number of prescribed medications divided by the number of indicated medications) and the proportion of patients who were prescribed the complete set of necessary medications (patients lacking one or more required prophylactic drug were defined as incompletely treated). The prescription of certain drugs was dependent on cut-off levels (lipid-lowering therapy, arterial hypertension) or the presence of diabetes mellitus (defined according to WHO-criteria) [2][3][4][18][19][20]24]. Neglected measurement of lipid levels during hospital stay accounted as non-adherence as well as co-existent diabetes mellitus and/or arterial hypertension without a corresponding therapy (lifestyle changes and/or pharmacotherapy) or without an explicit suggestion for appropriate follow up.…”

Section: Study Protocolmentioning

confidence: 99%

“…The pharmalogical secondary prophylaxis of cardiovascular risk factors has proven useful in lowering morbidity and mortality in coronary artery disease, and numerous international recommendations guide physicians towards a more adequate prescription of these drugs [1,[2][3][4]. Over the last few years several studies have demonstrated clear improvements in the pharmacological prevention of coronary artery disease [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of in-hospital secondary prevention for different vascular diseases

Perren

Cerutti

Lazzaro

et al. 2009

European Journal of Internal Medicine

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Background: Secondary prevention of coronary artery disease is highly effective and implemented on a large scale. However, studies testing adherence to recommended secondary prevention of other vascular diseases are rare. Our goal was to evaluate whether the kind of vascular disease influences prescription practice of secondary drug prophylaxis at hospital discharge and to which extent secondary prevention is actually complete. Methods: A 3-month prospective observational review of the hospital discharge information of all patients hospitalized because of a vascular disease diagnosis: coronary artery disease (i. 3) for CVD. The proportion of patients who were prescribed a complete bundle of recommended medications was globally 29.5% (24.1-35.0). Conclusions: We found similar global prescription rates of secondary prevention for the different vascular diseases. However, only one third of the studied collective gets a complete set of required prophylactic drugs.

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Patient Knowledge of Coronary Risk Profile Improves the Effectiveness of Dyslipidemia Therapy

Grover

Lowensteyn²,

Joseph³

et al. 2007

Arch Intern Med

159

119

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Background: Despite increasing evidence that treating dyslipidemia reduces cardiovascular events, many patients do not achieve recommended lipid targets.Methods: To determine whether showing physicians and patients the patient's calculated coronary risk can improve the effectiveness of treating dyslipidemia in a primary care setting, patients were randomized to receive usual care or ongoing feedback regarding their calculated coronary risk and the change in this risk after lifestyle changes, pharmacotherapy, or both to treat dyslipidemia. Outcomes, based on intention-to-treat analysis, included changes in blood lipid levels, coronary risk, and the frequency of reaching lipid targets.Results: Two hundred thirty primary care physicians enrolled 3053 patients. After 12 months of follow-up, 2687 patients (88.0%) remained in the study. After adjustment for baseline lipid values, significantly greater mean reductions in low-density lipoprotein cholesterol levels and the total cholesterol to high-density lipoprotein cholesterol ratio were observed in patients receiving risk profiles (51.2 mg/dL[toconverttomillimolesperliter,multiplyby0.0259] and 1.5, respectively) vs usual care (48.0 mg/dL and 1.3, respectively), but the differences were small (−3.3 mg/dL; 95% confidence interval [CI], −5.4 to −1.1 mg/dL; and −0.1; 95% CI, −0.2 to −0.1, respectively). Patients in the risk profile group were also more likely to reach lipid targets (odds ratio, 1.26; 95% CI, 1.07 to 1.48). A significant dose-response effect was also noted when the impact of the risk profile was stronger in those with worse profiles.Conclusions: Discussing coronary risk with the patient is associated with a small but measurable improvement in the efficacy of lipid therapy. The value of incorporating risk assessment in preventive care should be further evaluated.

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European guidelines on cardiovascular disease prevention in clinical practice. third joint task force of european and other societies on cardiovascular disease prevention in clinical practice

Cited by 494 publications

References 0 publications

Assessment of Atherothrombosis and Its Treatment in Mexico: First‐Year Data of the REACH Registry

Assessment of Atherothrombosis and Its Treatment in Mexico: First‐Year Data of the REACH Registry

Comparison of in-hospital secondary prevention for different vascular diseases

Patient Knowledge of Coronary Risk Profile Improves the Effectiveness of Dyslipidemia Therapy

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