The chronic ischaemic cardiovascular disease ESC Pilot Registry: Results of the six-month follow-up

Abstract

Aim

Chronic ischaemic cardiovascular disease (CICD) remains a leading cause of morbidity and mortality worldwide. The CICD Pilot Registry enrolled 2420 patients across 10 European Society of Cardiology countries prospectively to describe characteristics, management strategies and clinical outcomes in this setting. We report here the six-month outcomes.

Methods and results

From the overall population, 2203 patients were analysed at six months. Fifty-eight patients (2.6%) died after inclusion; 522 patients (23.7%) experienced all-cause hospitalisation or death. The rate of prescription of angiotensin-converting enzyme inhibitors, beta-blockers and aspirin was mildly decreased at six months (all P < 0.02). Patients who experienced all-cause hospitalisation or death were older, more often had a history of non-ST-segment elevation myocardial infarction, of chronic kidney disease, peripheral revascularisation and/or chronic obstructive pulmonary disease than those without events. Independent predictors of all-cause mortality/hospitalisation were age (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07–1.27) per 10 years, and a history of previous peripheral revascularisation (HR 1.45, 95% CI 1.03–2.03), chronic kidney disease (HR 1.31, 95% CI 1.0–1.68) or chronic obstructive pulmonary disease (HR 1.42, 95% CI 1.06–1.91, all P < 0.05). We observed a higher rate of events in eastern, western and northern countries compared to southern countries and in cohort 1.

Conclusion

In this contemporary European registry of CICD patients, the rate of severe clinical outcomes at six months was high and was influenced by age, heart rate and comorbidities. The medical management of this condition remains suboptimal, emphasising the need for larger registries with long-term follow-up. Ad-hoc programmes aimed at implementing guidelines adherence and follow-up procedures are necessary, in order to improve quality of care and patient outcomes.

Keywords

Registries outcomes ischaemic cardiovascular disease stable angina

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References

Leal

Luengo-Fernandez

Gray

et al.

Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J 2006; 27: 1610–1619.

Tunstall-Pedoe

Kuulasmaa

Mahonen

et al.

Contributions of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. Lancet 1999; 353: 1547–1557.

Murray

Lopez

. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997; 349: 1498–1504.

Komajda

Weidinger

Kerneis

et al.

EURObservational Research Programme: the Chronic Ischaemic Cardiovascular Disease Registry: pilot phase (CICD–PILOT). Eur Heart J 2016; 37: 152–160.

Steg

Bhatt

Wilson

et al.

One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297: 1197–1206.

Steg

Greenlaw

Tendera

et al.

Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry. JAMA Intern Med 2014; 174: 1651–1659.

Kotseva

Wood

De Bacquer

et al.

EUROASPIRE IV: a European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol 2016; 23: 636–648.

Sorbets

Labreuche

Simon

et al.

Renin–angiotensin system antagonists and clinical outcomes in stable coronary artery disease without heart failure. Eur Heart J 2014; 35: 1760–1768.

Bangalore

Steg

Deedwania

et al.

β-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012; 308: 1340–1349.

10.

Eisen

Bhatt

Steg

et al.

Angina and future cardiovascular events in stable patients with coronary artery disease: insights from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. J Am Heart Assoc 2016; 5: e004080–e004080.

11.

Mahaffey

Wojdyla

Pieper

et al.

Comparison of clinical trial outcome patterns in patients following acute coronary syndromes and in patients with chronic stable atherosclerosis. Clin Cardiol 2014; 37: 337–342.

12.

Alcock

Yong

ASC

ACC

et al.

Acute coronary syndrome and stable coronary artery disease: are they so different? Long-term outcomes in a contemporary PCI cohort. Int J Cardiol 2013; 167: 1343–1346.

13.

Ducrocq

Bhatt

Labreuche

et al.

Geographic differences in outcomes in outpatients with established atherothrombotic disease: results from the REACH Registry. Eur J Prev Cardiol 2014; 21: 1509–1516.

14.

Ferrari

Ford

Greenlaw

et al.

Geographical variations in the prevalence and management of cardiovascular risk factors in outpatients with CAD: data from the contemporary CLARIFY registry. Eur J Prev Cardiol 2015; 22: 1056–1065.

15.

Cavender

Steg

Smith

Jr et al.

Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation 2015; 132: 923–931.

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