Modifiable risk factors control and its relationship with 1 year outcomes after coronary artery bypass surgery: insights from the REACH registry.
Rajendra H. Mehta,Rajendra H. Mehta,Deepak L. Bhatt,Ph. Gabriel Steg,Shinya Goto,Alan T. Hirsch,Chiau Suong Liau,Joachim Röther,Peter W.F. Wilson,Alain J. Richard,Kim A. Eagle,E. Magnus Ohman,E. Magnus Ohman +12 more
TLDR
Primary prevention after CABG needs to focus on more comprehensive modification of risk factors to target goals in the hope of preventing subsequent CV events, and represents an opportunity to improve CV health.Abstract:
Aims To evaluate the influence of achieving secondary prevention target treatment goals for cardiovascular (CV) risk factors on clinical outcomes in patients with prior coronary artery bypass surgery (CABG).
Methods and results Accordingly, we analysed treatment to target goals in patients with prior CABG and atherothrombotic disease or known risk factors (diabetes, hypertension, hypercholesterolaemia, smoking, obesity) enrolled in the global REduction in Atherothrombosis for Continued Health (REACH) Registry, and their association with 1 year outcomes. A total of 13 907 of 68 236 patients (20.4%) in REACH had a history of prior CABG, and 1 year outcomes data were available for 13 207 of these. At baseline 75% risk factors at goal, respectively; P for trend 0.059).
Conclusion Risk-factor control varied greatly in CABG patients. Although CABG patients are frequently treated with appropriate therapies, these treatments fail to achieve an adequate level of prevention in many. This failure was associated with a trend for worse age-, gender-, and region-adjusted clinical outcomes. Thus, perhaps secondary prevention after CABG needs to focus on more comprehensive modification of risk factors to target goals in the hope of preventing subsequent CV events, and represents an opportunity to improve CV health.read more
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EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries:
Kornelia Kotseva,Kornelia Kotseva,David R. Wood,David R. Wood,Dirk De Bacquer,Dirk De Bacquer,Guy De Backer,Guy De Backer,Lars Rydén,Lars Rydén,Catriona Jennings,Catriona Jennings,Viveca Gyberg,Philippe Amouyel,Jan Bruthans,Jan Bruthans,Almudena Castro Conde,Renata Cifkova,Renata Cifkova,J.W. Deckers,Johan De Sutter,Johan De Sutter,Mirza Dilic,Mirza Dilic,Maryna Dolzhenko,Andrejs Erglis,Andrejs Erglis,Zlatko Fras,Zlatko Fras,Dan Gaita,Nina Gotcheva,John A. Goudevenos,John A. Goudevenos,Peter U. Heuschmann,Aleksandras Laucevičius,Aleksandras Laucevičius,Seppo Lehto,Dragan Lovic,Davor Milicic,Davor Milicic,David Moore,Evagoras Nicolaides,Evagoras Nicolaides,Raphael Oganov,Andrzej Pajak,Nana Pogosova,Zeljko Reiner,Zeljko Reiner,Martin Stagmo,Stefan Störk,Lale Tokgozoglu,Lale Tokgozoglu,Dusko Vulic,Dusko Vulic +53 more
TL;DR: A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes.
Journal ArticleDOI
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry.
Kornelia Kotseva,Kornelia Kotseva,Guy De Backer,Guy De Backer,Dirk De Bacquer,Dirk De Bacquer,Lars Rydén,Lars Rydén,Arno W. Hoes,Arno W. Hoes,Diederick E. Grobbee,Diederick E. Grobbee,Aldo P. Maggioni,Pedro Marques-Vidal,Pedro Marques-Vidal,Catriona Jennings,Catriona Jennings,Ana Abreu,Carlos Aguiar,J. Badariene,Jan Bruthans,Jan Bruthans,Almudena Castro Conde,Renata Cifkova,Renata Cifkova,J Crowley,J Crowley,Kairat Davletov,Jaap W. Deckers,Jaap W. Deckers,Delphine De Smedt,Delphine De Smedt,Johan De Sutter,Johan De Sutter,Mirza Dilic,Mirza Dilic,Marina Dolzhenko,Vilnis Dzerve,Vilnis Dzerve,Andrejs Erglis,Andrejs Erglis,Zlatko Fras,Zlatko Fras,Zlatko Fras,Dan Gaita,Nina Gotcheva,Peter U. Heuschmann,Hosam Hasan-Ali,Piotr Jankowski,Nebojsa Lalic,Seppo Lehto,Dragan Lovic,S. Mancas,Linda Mellbin,Linda Mellbin,Davor Milicic,Davor Milicic,Erkin M. Mirrakhimov,Erkin M. Mirrakhimov,Rafael G. Oganov,Nana Pogosova,Zeljko Reiner,Zeljko Reiner,S Stoerk,Lâle Tokgözoğlu,Lâle Tokgözoğlu,Costas Tsioufis,Costas Tsioufis,Dusko Vulic,David R. Wood,David R. Wood,David R. Wood +71 more
TL;DR: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors, and a majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets.
Journal ArticleDOI
Secondary Prevention After Coronary Artery Bypass Graft Surgery A Scientific Statement From the American Heart Association
Alexander Kulik,Marc Ruel,Hani Jneid,T. Bruce Ferguson,Loren F. Hiratzka,John S. Ikonomidis,Francisco Lopez-Jimenez,Sheila M McNallan,Mahesh J. Patel,Véronique L. Roger,Frank W. Sellke,Domenic A. Sica,Lani Zimmerman +12 more
TL;DR: This nationwide study sought to rigorously test on a national scale whether low-intensity continuous quality improvement interventions can be used to speed secondary prevention adherence after coronary artery bypass grafting.
Journal ArticleDOI
Risk Factor Control for Coronary Artery Disease Secondary Prevention in Large Randomized Trials
Michael E. Farkouh,William E. Boden,Vera Bittner,Victoria Muratov,Pamela M. Hartigan,May Ogdie,Marnie Bertolet,Shiny Mathewkutty,Koon K. Teo,David J. Maron,Sanjum S. Sethi,Michael J. Domanski,Robert L. Frye,Valentin Fuster,Valentin Fuster +14 more
TL;DR: A significant proportion of diabetic CAD patients fail to achieve pre-specified targets for 4 major modifiable cardiovascular risk factors in clinical trials, and fundamentally new thinking is needed to explore approaches to achieve optimal secondary prevention treatment goals.
Journal ArticleDOI
Time Trends in Lifestyle, Risk Factor Control, and Use of Evidence-Based Medications in Patients With Coronary Heart Disease in Europe: Results From 3 EUROASPIRE Surveys, 1999–2013
Kornelia Kotseva,Dirk De Bacquer,Catriona Jennings,Viveca Gyberg,Guy De Backer,Lars Rydén,Philippe Amouyel,Jan Bruthans,Renata Cifkova,Jaap W. Deckers,Johan De Sutter,Zlatko Fraz,Ian D. Graham,Irena Keber,Seppo Lehto,David Moore,Andrzej Pajak,David R. Wood,Euroaspire Investigators +18 more
TL;DR: Lifestyle habits have deteriorated over time with increases in obesity, central obesity, and diabetes and stagnating rates of persistent smoking and the use of evidence-based medications appears to have stalled apart from the increased use of high-intensity statins.
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International Prevalence, Recognition, and Treatment of Cardiovascular Risk Factors in Outpatients With Atherothrombosis
Deepak L. Bhatt,P. Gabriel Steg,E. Magnus Ohman,Alan T. Hirsch,Yasuo Ikeda,Jean-Louis Mas,Shinya Goto,Chiau Suong Liau,Alain J. Richard,Joachim Röther,Peter W.F. Wilson +10 more
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TL;DR: Aggressive lowering of LDL cholesterol levels to below 100 mg per deciliter reduced the progression of atherosclerosis in grafts and low-dose warfarin did not reduce the progression in patients with aortocoronary bypass grafts.
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