Substantial improvement of primary cardiovascular prevention by a systematic score-based multimodal approach: A randomized trial: The PreFord-Study

Abstract

intention-to-treat and per-protocol analysis. Results Four hundred and forty-seven subjects were randomized to INT ( n = 224) or to usual care ( n = 223). After 36 months ESC-SCORE development favouring INT was observed (INT: 8.70% to 10.03% vs. usual care: 8.49% to 12.09%; p = 0.005; net difference: 18.50%). Moreover, a significant reduction in the composite cardiovascular events was observed: (INT: n = 11 vs. usual care: n = 27). Hazard ratio of intervention versus control was 0.51 (95% confidence interval 0.25-1.03; p = 0.062) in the intention-to-treat analysis and 0.41 (95% confidence interval 0.18-0.90; p = 0.026) in the per-protocol analysis, respectively. No intervention-related adverse events or side-effects were observed. Conclusions Our results demonstrate the efficiency of identifying cardiovascular high-risk subjects by the ESC-SCORE in order to enrol them to a risk adjusted primary prevention programme. This strategy resulted in a significant improvement of ESC-SCORE, as well as a reduction in predefined cardiovascular endpoints in the INT within 36 months. (ISRCTN 23536103.).

Coronary artery calcium and carotid artery intima-media thickness for the prediction of stroke and benefit from statins

“…For primary prevention of ASCVD, guidelines issued by the European Society of Cardiology (ESC) recommend cardiovascular risk stratification to use the Systematic COronary Risk Evaluation (ESC-SCORE) algorithm to predict fatal ASCVD. 26 It could predict cardiovascular events well; 27,28 however, the problem of overestimation is similar with US preventive guidelines. 3,29 A recent investigation has shown that the CAC score could well differentiate the risk for future cardiovascular events in the ACC/AHA Pooled Risk Cohort as well as the ESC-SCORE algorithm.…”

Editor’s presentation

“…Indeed, this strategy resulted in a significant reduction of the ESC-SCORE in the treated group, which was also associated with a reduction of predefined cardiovascular endpoints. 1 Interestingly, only 28% of invited persons participated in the risk screening, which is a comparable responder rate to other primary prevention studies.…”

Cost-effectiveness of rivaroxaban plus aspirin (dual pathway inhibition) for prevention of ischaemic events in patients with cardiovascular disease: on top optimisation of secondary prevention medication in the context of COVID-19 pandemia

“…On the other hand, the consequent utilisation of well-structured and supervised prevention and rehabilitation programmes will help to enforce prevention strategies and thereby also help to introduce innovative therapies sustainably in clinical all day care. [17][18][19] 'From the top back to baseline' When writing this editorial COVID-19 threatens every country all over the world. At this time neither effective vaccination nor targeted therapeutic options are available, but patients with CVD and/or diabetes are known to be of special risk of dying from Sars-CoV-2 infection.…”