EUROASPIRE-IV: Study of the European Society of Cardiology on Lifestyle, Risk Factors, and Treatment Approaches in Patients with Coronary Artery Disease: Data from Turkey

2016 ◽  
Author(s):  
Lale Tokgozoglu
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
European Society ◽  
Treatment Approaches ◽  
Lifestyle Risk Factors ◽  
Artery Disease ◽  
Lifestyle Risk ◽  
European Society Of Cardiology

P2681The impact of modifiable life style risk factors on inflammation in patients with coronary artery disease: modelling a target population for anti-inflammatory treatment

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Blaum ◽  
F J Brunner ◽  
J Braetz ◽  
F Kroeger ◽  
A Gossling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Linear Regression ◽  
Target Population ◽  
P Value ◽  
Lifestyle Risk Factors ◽  
Artery Disease ◽  
Lifestyle Risk ◽  
Inflammatory Burden

Abstract Introduction Modifiable lifestyle risk factors (modRF) of coronary artery disease (CAD) such as smoking, lack of physical activity (PA) and poor diet are associated with high inflammatory burden. An optimisation of modRF might significantly affect the target population for pharmacological anti-inflammatory treatment (AIT) as determined by a hsCRP ≥2 mg/l. Aim To analyse the influence of modRF on hsCRP in a contemporary CAD cohort and model the effect of modRF optimisation on hsCRP in a target population with high inflammatory burden. Methods We included all patients with angiographically documented CAD from an observational cohort study ongoing since 2015 and excluded patients with recent myocardial infarction, malignancy, infectious disease, and immunosuppressive medication. ModRF were assessed by questionnaire at enrolment. Lack of PA was defined as PA <1.5 h/week and poor diet as ≤12 points of an established Mediterranean diet score (MDS, range 0–28 points). The Kruskall-Wallis Test was used to compare hsCRP levels depending on the number of modRF. We performed univariate and multivariate linear regression with log(hsCRP) as the dependent variable. Based on the latter we recalculated hsCRP for each patient assuming optimisation of individual modRF. Results Of the 1003 patients (mean age 69 years, 72% male) included, 48% (N=479) had a hsCRP ≥2 mg/l. HsCRP increased with the incremental number of modRF (median hsCRP-values for 0–3 modRF: 1.1, 1.6, 2.1, 2.7 mg/l, p<0.001). Univariate and multivariate linear regression showed a significant association between log(hsCRP) and each of PA ≥1.5 h/week, MDS >12, and smoking (Table 1). Recalculation of hsCRP levels identified 21% (N=102/479) of patients with hsCRP ≥2 mg/l who could achieve a hsCRP <2 mg/l assuming optimisation of present modRF. Table 1. Linear regression results Univariate Multivariate exp(β) (95% CI) p-value exp(β) (95% CI) p-value PA ≥1.5 h/week 0.63 (0.54, 0.72) <0.001 0.76 (0.66, 0.88) <0.001 MDS >12 0.74 (0.65, 0.86) <0.001 0.83 (0.73, 0.96) <0.010 Smoking 1.16 (1.01, 1.34) <0.040 1.19 (1.03, 1.36) <0.017 Impact of modifiable lifestyle risk factors on hsCRP in 1003 CAD patients. Multivariate analyses are adjusted for age, sex, diabetes, body mass index and intake of cholesterol lowering drugs. Conclusion Modifiable lifestyle risk factors are independently associated with hsCRP levels in CAD patients. A relevant portion of patients with high inflammatory burden might achieve a hsCRP <2 mg/l by lifestyle changes alone. This should be considered in view of the cost and side-effects of pharmacological AIT and for the design of future intervention studies in this field.

Validation of the European Society of Cardiology pre-test probability model for obstructive coronary artery disease

2020 ◽  
Author(s):  
Simon Winther ◽  
Samuel Emil Schmidt ◽  
Laust Dupont Rasmussen ◽  
Luis Eduardo Juárez Orozco ◽  
Flemming Hald Steffensen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
European Society ◽  
Probability Model ◽  
Invasive Coronary Angiography ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease ◽  
European Society Of Cardiology ◽  
Test Probability

Abstract Aims  Estimation of pre-test probability (PTP) of disease in patients with suspected coronary artery disease (CAD) is a common challenge. Due to decreasing prevalence of obstructive CAD in patients referred for diagnostic testing, the European Society of Cardiology suggested a new PTP (2019-ESC-PTP) model. The aim of this study was to validate that model. Methods and results  Symptomatic patients referred for coronary computed tomography angiography (CTA) due to suspected CAD in a geographical uptake area of 3.3 million inhabitants were included. The reference standard was a combined endpoint of CTA and invasive coronary angiography (ICA) with obstructive CAD defined at ICA as a ≥50% diameter stenosis or fractional flow reserve ≤0.80 when performed. The 2019-ESC-PTP, 2013-ESC-PTP, and CAD Consortium basic PTP scores were calculated based on age, sex, and symptoms. Of the 42 328 identified patients, coronary stenosis was detected in 8.8% using the combined endpoint. The 2019-ESC-PTP and CAD Consortium basic scores classified substantially more patients into the low PTP groups (PTP &lt; 15%) than did the 2013-ESC-PTP (64% and 65% vs. 16%, P &lt; 0.001). Using the combined endpoint as reference, calibration of the 2019-ESC-PTP model was superior to the 2013-ESC-PTP and CAD Consortium basic score. Conclusion  The new 2019-ESC-PTP model is well calibrated and superior to the previously recommended models in predicting obstructive stenosis detected by a combined endpoint of CTA and ICA.

scholarly journals Using of questionnaire of European Society of Cardiology to identify non-conventional risk factors in patients with coronary artery disease in the Kyrgyz Republic

2019 ◽  
pp. 76-80
Author(s):  
Yu. V. Zalesskaya ◽  
R. B. Kydyralieva
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Standard Treatment ◽  
Treatment Goals ◽  
Target Level ◽  
Type D ◽  
Artery Disease ◽  
European Society Of Cardiology ◽  
Conventional Risk Factors

Aim.To analyze the results of using of the European Society of Cardiology (ESC) questionnaire regarding the assessment of non-conventional risk factors in patients with coronary artery disease (CAD).Material and methods. Three hundred and ten patients with CAD (mean age 59,6±8,8 years, men 62,2) underwent a general clinical examination with the identification of conventional risk factors and assessing standard treatment goals. The cardiologist performed a two-stage assessment of non-conventional risk factors using the ESC questionnaire and validated questionnaires (DS-14, Hamilton Rating Scale for Depression and Anxiety) for clinical identification of anxiety, depression, type D personality.Results.In hospitalized patients, predominantly we noted severe clinical manifestations of the disease: acute coronary syndrome (51,6%), a decrease in the ejection fraction of less than 50% (40%), a history of acute myocardial infarction (29%), and a high frequency of conventional risk factors: arterial hypertension (75,8%), dyslipidemia (75,1%), obesity (40,9%). The majority of respondents did not reach the standard treatment goals: 13,8% of patients smoked, 30,9% did not follow the lipid-lowering diet, 81,3% did not follow recommendations regarding fish eating, 51,6% did not have recommended physical activity, 40,6% did not reached the target level of blood pressure, 59,3% — the target level of low-density lipoproteins, 59,8% — the target level of body mass index. We determined prevalence of following non-conventional risk factors: hostility (30,9%), type D personality (25,4%), low socio-economic status (12,2%) and anxiety (10%). Depression (5,1%), stress at work and in family life (4,5%), social exclusion (1,6%) were less common.Conclusion.The results are consistent with data obtained by foreign researchers. The use of the ESC questionnaire allows practitioners to focus on identifying nonconventional risk factors, receive data on the individual risk profile and expand the range of treatment and prevention strategies.

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