Prevenzione secondaria nella malattia coronarica

Sorbets, Emmanuel; Lallmahomed, E.; Kretz, Sandrine; Cinaud, Alexandre; Vallée, Alexandre; Lelong, Hélène; Blachier, Vincent; Blacher, Jacques

doi:10.1016/s1634-7358(21)44575-4

Cited by 1 publication

(4 citation statements)

References 29 publications

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“…The aim of secondary preventive therapy of CAD is to slow down the progression of the atherosclerosis and prevent its severe clinical manifestations. This can be reached by means of the integration between the non-pharmacological management of risk factors (i.e., lifestyle counselling, especially smoking cessation, dietary changes, and weight reduction) and specific pharmacological treatments for both traditional, modifiable risk factors and comorbidities [1,2,9,10].…”

Section: Demographics and Clinical Characteristicsmentioning

confidence: 99%

“…Although the prevalence and mortality rates of coronary artery disease (CAD) had decreased by the early 1980s in Europe, they continue to remain high, with 9.2% of the European population affected by CAD and more than 1,700,000 patients dying every year [1,2]. CAD can be the consequence of long-term atherosclerotic disease, but its dynamic progression can unexpectedly lead to adverse events, such as myocardial infarction (MI), and stroke and cardiovascular (CV) death [1,3]. CAD mortality and hospitalization rates could be halved by modest risk factor reductions [2].…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes is another relevant, independent risk factor for CAD, and its appropriate management can reduce the risk of micro-and macro-vascular outcomes and related mortality [6]. Elevated blood pressure is a major risk factor for CAD [1,2]. The combination therapy is based on blood pressure level and total CAD risk; diuretics, angiotensin-converting enzyme inhibitors (ACE-is), angiotensin receptor blockers (ARBs), calcium antagonists, and β-blockers are all recommended [1,2,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…The combination therapy is based on blood pressure level and total CAD risk; diuretics, angiotensin-converting enzyme inhibitors (ACE-is), angiotensin receptor blockers (ARBs), calcium antagonists, and β-blockers are all recommended [1,2,7,8]. Antiplatelets significantly reduce the occurrence of clinical events for CAD; acetylsalicylic acid and P2Y12 inhibitors can be variously prescribed based on a case-by-case balance between ischemic benefit and the risk of bleeding [1,9], whereas oral anticoagulants are only indicated in specific cases [4,10]. Finally, several anti-inflammatory drugs are under evaluation to prevent the progression of coronary atherosclerosis and related atherothrombotic events (e.g., colchicine and canakinumab) [6].…”

Section: Introductionmentioning

confidence: 99%

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Coronary Artery Disease in Patients Older than 35 and Eligible for Cardiovascular Secondary Prevention: An Italian Retrospective Observational Analysis of Healthcare Administrative Databases

Calabria¹,

Ronconi²,

Dondi³

et al. 2021

JCM

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Background: This study describes patients with coronary artery disease (CAD) who are eligible for secondary prevention and assesses their healthcare consumption and costs from the perspective of the Italian National Health Service (INHS). Methods: From the Fondazione Ricerca e Salute’s database, which collects Italian healthcare administrative data, all patients aged ≥ 35, with ≥1 primary in-hospital CAD diagnosis and/or procedure on the coronary arteries, or with the specific disease exemption code, and who are suitable for long-term secondary prevention treatments, were identified in 2018 and analyzed. Demographics, comorbidities, one-year supplied drugs, hospitalizations, and costs were analyzed. Results: From >3 million inhabitants aged ≥ 35, 46,063 (1.3%) were identified (72.1% males, mean age 70 ± 12; approximately 50% with ≥3 comorbidities). During a one-year follow-up, 96.4% were treated with ≥1 drug for secondary prevention (mainly antiplatelets and lipid lowering agents), 69.4% with ≥1 concomitant cardiovascular drug, and 95.8% with ≥1 concomitant non-cardiovascular therapy. Within one year, 30.6% of patients were hospitalized at least once, mostly due to non-cardiovascular events. Calculated by mean, the INHS paid EUR 6078 per patient. Conclusions: This analysis confirms the relevant burden of CAD for patients with many comorbidities and who are frequently hospitalized, and the burden on the INHS. A multidisciplinary healthcare approach is encouraged to improve patients’ outcomes and reduce costs for the INHS.

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Section: Demographics and Clinical Characteristicsmentioning

confidence: 99%