scholarly journals Profile and treatment of chronic coronary syndromes in European Society of Cardiology member countries

2020 ◽  
pp. 204748732091249 ◽  
Author(s):  
Michel Komajda ◽  
Francesco Cosentino ◽  
Roberto Ferrari ◽  
Mathieu Kerneis ◽  
Elena Kosmachova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Enzyme Inhibitor ◽  
Antiplatelet Agent ◽  
Initial Contact ◽  
Ambulatory Visit ◽  
Coronary Syndromes ◽  
European Society Of Cardiology

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.

Sensitivity, specificity of pre-test probability and their use in the relation to syntax score and cardiovascular risk factors

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Syntax Score ◽  
Model Group ◽  
European Society Of Cardiology ◽  
Test Probability

Overview: Coronary angiography is the gold standard for definitive diagnosis of obstructive ischemic coronary disease. However, this is an invasive, expensive test, and may have a number of complications. Models of pre-test probability (PTP) in the guideline of the European Society of Cardiology 2013 and 2019 are easy to use and apply even to doctors who are not cardiologists, and can be implemented at the medical facilities. We aim to assess the sensitivity and specificity of different PTP stratification models follow ESC2013 and 2019; and their use in the relation to SYNTAX score and cardiovascular risk factors. Materials and Methods: Patients (n=108) with chest pain had been treated at Ninh Thuan Provincial Hospital from January 2019 to May 2020. The PTP stratification models were calculated according to the recommendations of the European Society of Cardiology (ESC) 2013 and 2019. Coronary angiography was enrolled for the diagnosis, Quantitative coronary analyzed (QCA) - based stenosis assessment was used with a cut-off of ≥ 50% diameter reduction for significant lesions of coronary artery and SYNTAX score were calculated.Diagnostic accuracy was calculated by usingsensitivity, specificitywhich were analyzed by using statistical software SPSS version 20.0. Results: In the 2013 pre-test probability model,group withmedium PTP andhigh PTPhad the sensitivity of 57.14%, 100% respectively; the overall sensitivity for both groups (the medium and high pre-test) was 59.36%; and the specificity was 58.33%. In the 2019PTP model, group withmedium PTP and high PTP had the sensitivity of 41.67%, of 67.57% respectively;the overall sensitivity for both groups (the medium and high scores PTP) was 61.22%; and the specificity was 80%. The group of low SYNTAXscore (<23) had at most 93 cases, accounting for 86.1%; the lowest was the group of high SYNTAX score (≥ 33 points) accounting for 2.8%. There were statistically significant differences in patients with and without smoking, history of hypertension for both PTP model 2013 and 2019. Conclusion: Sensitivity and specificity of the 2013 and 2019 PTP were quite high in the relation to the severity of coronary artery which were evaluated by SYNTAX score.

scholarly journals Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)

2009 ◽  
Vol 24 (6) ◽  
pp. 412-424 ◽  
Author(s):  
M. De Hert ◽  
J.M. Dekker ◽  
D. Wood ◽  
K.G. Kahl ◽  
R.I.G. Holt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Severe Mental Illness ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
European Association ◽  
Mental Illnesses ◽  
European Society Of Cardiology

AbstractPeople with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and possibly other psychotropic medication like antidepressants can induce weight gain or worsen other metabolic cardiovascular risk factors. Patients may have limited access to general healthcare with less opportunity for cardiovascular risk screening and prevention than would be expected in a non-psychiatric population. The European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) published this statement with the aim of improving the care of patients suffering from severe mental illness. The intention is to initiate cooperation and shared care between the different healthcare professionals and to increase the awareness of psychiatrists and primary care physicians caring for patients with severe mental illness to screen and treat cardiovascular risk factors and diabetes.

Modification of Cardiovascular Risk Factors during Antihypertensive Treatment: A Multicentre Trial with Quinapril

1993 ◽  
Vol 21 (1) ◽  
pp. 15-25 ◽  
Author(s):  
E Manzato ◽  
A Capurso ◽  
G Crepaldi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Enzyme Inhibitor ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Intent To Treat

A large multicentre study involving 6003 [3044 males, 2959 females; mean (± SD) age 59 ± 11 years] mild-to-severe hypertensive patients was carried out to evaluate the effects of the angiotension converting enzyme inhibitor quinapril on blood pressure and on metabolic cardiovascular risk factors during 3 − 6 months' treatment (mean follow-up 90.4 days). The study population included 551 elderly [mean (± SD) age 71.9 ± 9.3 years] patients, 1314 subjects with diabetes mellitus and 154 non-diabetic patients with hyperlipaemia; 4% of patients were lost to follow-up. Diastolic blood pressure decreased from 102 to 87 mmHg (intent-to-treat analysis) and 62% of patients were normalized (diastolic blood pressure below 90 mmHg) at the last evaluable visit. Overall, serum lipids were favourably affected during quinapril treatment; when corrected for changes in body weight, a significant improvement in total, low- and high-density lipoprotein cholesterol, and triglycerides was detected. Quinapril treatment in elderly patients was efficacious and well tolerated, and quinapril appears to be an effective antihypertensive drug devoid of untoward effects on metabolic risk factors for cardiovascular disease.

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