TY  - JOUR
A1  - Gyberg, Viveca
A1  - De Bacquer, Dirk
A1  - De Backer, Guy
A1  - Jennings, Catriona
A1  - Kotseva, Kornelia
A1  - Mellbin, Linda
A1  - Schnell, Oliver
A1  - Tuomilehto, Jaakko
A1  - Wood, David
A1  - Ryden, Lars
A1  - Amouyel, Philippe
A1  - Bruthans, Jan
A1  - Conde, Almudena Castro
A1  - Cifkova, Renata
A1  - Deckers, Jaap W.
A1  - De Sutter, Johan
A1  - Dilic, Mirza
A1  - Dolzhenko, Maryna
A1  - Erglis, Andrejs
A1  - Fras, Zlatko
A1  - Gaita, Dan
A1  - Gotcheva, Nina
A1  - Goudevenos, John
A1  - Heuschmann, Peter
A1  - Laucevicius, Aleksandras
A1  - Lehto, Seppo
A1  - Lovic, Dragan
A1  - Milicic, Davor
A1  - Moore, David
A1  - Nicolaides, Evagoras
A1  - Oganov, Raphae
A1  - Pajak, Andrzej
A1  - Pogosova, Nana
A1  - Reiner, Zeljko
A1  - Stagmo, Martin
A1  - Störk, Stefan
A1  - Tokgözoglu, Lale
A1  - Vulic, Dusko
T1  - Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology
JF  - Cardiovascular Diabetology
N2  - Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. 
Methods: A total of 6187 patients (18-80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012-2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46 %) patients had no diabetes, 1158 (19 %) newly diagnosed diabetes and 2183 (35 %) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60 %, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54 % and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28 %. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0 % (53 mmol/mol) in 95 and 53 % and 11 % of those with previously known diabetes had an HbA1c >9.0 % (>75 mmol/mol). Of the patients with diabetes 69 % reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (approximate to 40 %) and only 27 % of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. 
Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.
KW  - heart
KW  - glycaemic control
KW  - cardiovascular diseases
KW  - myocardial infarction
KW  - glucose control
KW  - blood-glucose
KW  - risk factors
KW  - follow-up
KW  - mellitus
KW  - mortality
KW  - guidelines
KW  - coronary artery disease
KW  - type 2 diabetes
KW  - secondary prevention
KW  - management
KW  - guideline adherence
KW  - blood pressure
KW  - blood lipids
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-141358
VL  - 14
IS  - 133
ER  -