Rationale, design, and baseline characteristics of the <scp>CLARIFY</scp> registry of outpatients with stable coronary artery disease

Sorbets, Emmanuel; Greenlaw, Nicola; Ferrari, Roberto; Ford, Ian; Fox, Kim; Tardif, Jean‐Claude; Tendera, Michał; Steg, Philippe Gabríel

doi:10.1002/clc.22730

Cited by 40 publications

(48 citation statements)

References 37 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rationale, design, and baseline characteristics of the entire CLARIFY population have been previously published. 16,17 Briefly, 32 703 ambulatory patients with chronic CAD were enrolled between November 2009 and June 2010 in 45 countries in Europe, Middle East, Asia, Africa, and North and South America. Patients had to fulfil at least one of the following criteria to be eligible for the study: MI or coronary revascularization [coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)] >3 months before enrolment, coronary stenosis >50% on angiography, or angina with documented myocardial ischaemia.…”

Section: Methodsmentioning

confidence: 99%

Incident heart failure in outpatients with chronic coronary syndrome: results from the international prospective CLARIFY registry

Parma

Jasilek

Greenlaw

et al. 2020

European J of Heart Fail

Self Cite

View full text Add to dashboard Cite

Aim The contemporary incidence of heart failure (HF) in patients with chronic coronary syndrome is unclear. We aimed to study the incidence and predictors of cardiovascular (CV) death, HF hospitalization or new‐onset HF not requiring hospitalization, in patients included in the CLARIFY registry. Methods and results CLARIFY is a contemporary, international registry of ambulatory patients with chronic coronary artery disease, conducted in 45 countries. At baseline, data on demographics, ethnicity, CV risk factors, medical history, cardiac parameters and medication were collected. Patients were followed up yearly up to 5 years. In this analysis, 26 769 patients with no HF history were included. At 5‐year follow‐up, 4393 patients (16.4%) reached the primary endpoint comprising CV death, HF hospitalization, or new‐onset HF. Only 16.7% of them (n = 732) required hospitalization for HF. All‐cause death occurred in 6.6% of patients (61.4% were CV). Age over 70 years, left ventricular ejection fraction <50%, Canadian Cardiovascular Society class ≥2 angina, atrial fibrillation or paced rhythm on the ECG, body mass index <20 kg/m2, and a history of stroke, were the most robust predictors of the primary outcome. Age <50 years, Asian ethnicity, and percutaneous revascularization were negative predictors of the outcome. Conclusion A sizeable proportion of patients with chronic coronary syndrome develop HF, which only infrequently requires hospitalization. Early identification of patients with HF may lead to early treatment, and help to further decrease mortality and morbidity. This concept needs confirmation in future studies.

show abstract

Section: Methodsmentioning

confidence: 99%

Incident heart failure in outpatients with chronic coronary syndrome: results from the international prospective CLARIFY registry

Parma

Jasilek

Greenlaw

et al. 2020

European J of Heart Fail

Self Cite

View full text Add to dashboard Cite

show abstract

“…CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable coronary artery disease, with yearly followup for up to 5 years. 10 The 'chronic ischaemic cardiovascular disease' (CICD) registry was established by the European Society of Cardiology (ESC) to investigate the characteristics of a broad spectrum of contemporary patients with chronic coronary syndrome (CCS) from ESC member countries. A previous pilot CICD study validated the structure, performance and feasibility of the registry, as well as the quality of the data set.…”

Section: Introductionmentioning

confidence: 99%

Profile and treatment of chronic coronary syndromes in European Society of Cardiology member countries: The ESC EORP CICD-LT registry

Komajda

Cosentino

Ferrari

et al. 2020

European Journal of Preventive Cardiology

Self Cite

View full text Add to dashboard Cite

Background International guidelines recommend pharmacotherapy combinations for chronic coronary syndromes (CCSs) but medical management remains suboptimal. Design The CICD-LT registry is investigating short- and long-term outcomes and management in patients in European Society of Cardiology (ESC) member countries, in a longitudinal ESC EURObservational Research Programme aimed at improving CCS management. Methods Between 1 May 2015 and 31 July 2018, 9174 patients with previous ST-elevation myocardial infarction (STEMI), non-STEMI or coronary revascularisation, or other CCS, were recruited during a routine ambulatory visit or elective revascularisation procedure. Baseline clinical data were recorded and prescribed medications analysed at initial contact and discharge, and according to patient gender and age (<75 vs. ≥75 years). Results Poorly controlled cardiovascular risk factors, including current smoking (18.5%), obesity (33.9%), diabetes (25.8%), raised low-density lipoprotein cholesterol (73.3%) and persistent hypertension (24.7%), were common across all cohorts. At ambulatory visit or admission, the guidelines-recommended combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, aspirin, statin and any antiplatelet agent was prescribed to 57.8% of patients with STEMI/NSTEMI. Differences in prescribing rates, including for combination therapies, were observed based on age and gender and persisted after adjustment for demographic factors. Conclusions Cardiovascular risk factors were common in contemporary CCS patients and secondary prevention prescribing was suboptimal. Patients aged ≥75 years and, to some extent, female patients were less likely to receive guidelines-recommended drug combinations than younger and male patients. One- and two-year follow-up will study prescribing changes and associations between baseline characteristics/prescribing and subsequent clinical outcomes.

show abstract

“…When comparing the achieved level of secondary prevention and residual risk among common cardiovascular diseases, currently available information is from different observational studies designed as singledisease registries. [4][5][6][7][8] Differences in inclusion periods, the geographic distribution of the patients and healthcare systems may complicate the interpretation of these analyses. In the present study, patients with CAD, AF and/ or HF were included during the same period by the same group of referent cardiologists working in a limited geographic area within the same healthcare system.…”

Section: Resultsmentioning

confidence: 99%

“…[1][2][3] Observational studies carried out separately for each disease have provided information on how these recommendations translate into clinical practice and on the consequences in terms of outcomes in a real-life setting. [4][5][6][7][8] By design, these studies do not allow direct comparisons of the level of secondary prevention and/or residual risk from one disease to another. However, such data would be of interest, as this may help focus efforts on the individuals in greatest need.…”

Section: Introductionmentioning

confidence: 99%

Secondary prevention and outcomes in outpatients with coronary artery disease, atrial fibrillation or heart failure: a focus on disease overlap

et al. 2020

View full text Add to dashboard Cite

ObjectiveTo assess secondary prevention and outcomes in patients with chronic coronary artery disease (CAD), atrial fibrillation (AF) and heart failure (HF), focusing on disease overlap.MethodsWe analysed the data of 10 517 outpatients with a diagnosis of CAD, AF and/or HF included in a prospective cohort study. Follow-up (median 3.2 years) was achieved in 10 478 (99.6%) patients. Seven mutually exclusive patient groups were formed: CAD alone (n=4303), AF alone (n=2604), CAD+AF (n=700), HF alone (n=513), HF+CAD (n=728), HF+AF (n=1087) and HF+CAD+AF (n=582).ResultsPatients with disease overlaps represented 29.4% of the total population. The level of secondary prevention was high in all subgroups and in accordance with European class I – level A guidelines. Among patients with CAD, 99% received an antithrombotic and 91% received a statin. Among patients with AF, 81.7% were treated with an anticoagulant if indicated. Among HF patients with left ventricular ejection fraction <40%, 90.9% received a renin-angiotensin system antagonist and 91% a beta-blocker. Three-year all cause/cardiovascular mortality rates were: 6.4%/2%, 9.7%/3.3%, 15.6%/6.7%, 19.2%/9.4%, 24.3%/13.6%, 28%/15.7% and 35.4%/24.8%, for patients with CAD alone, AF alone, CAD+AF, HF alone, HF+CAD, HF+AF and HF+CAD+AF, respectively. In all groups with HF, observed all-cause mortality was higher (p<0.0001) than expected mortality for age-matched, gender-matched and geography-matched persons. In contrast, observed mortality was lower than expected for patients with CAD alone and AF alone (p<0.0001).ConclusionsIn a context of adequate secondary prevention, overlap between diseases is a frequent and high-risk situation with incremental increases in mortality. These patients deserve specific attention.

show abstract

Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease

Cited by 40 publications

References 37 publications

Incident heart failure in outpatients with chronic coronary syndrome: results from the international prospective CLARIFY registry

Incident heart failure in outpatients with chronic coronary syndrome: results from the international prospective CLARIFY registry

Profile and treatment of chronic coronary syndromes in European Society of Cardiology member countries: The ESC EORP CICD-LT registry

Secondary prevention and outcomes in outpatients with coronary artery disease, atrial fibrillation or heart failure: a focus on disease overlap

Contact Info

Product

Resources

About