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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

Please always quote using this URN: urn:nbn:de:bvb:20-opus-141358
  • 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 ofBackground: 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.show moreshow less

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Metadaten
Author: Viveca Gyberg, Dirk De Bacquer, Guy De Backer, Catriona Jennings, Kornelia Kotseva, Linda Mellbin, Oliver Schnell, Jaakko Tuomilehto, David Wood, Lars Ryden, Philippe Amouyel, Jan Bruthans, Almudena Castro Conde, Renata Cifkova, Jaap W. Deckers, Johan De Sutter, Mirza Dilic, Maryna Dolzhenko, Andrejs Erglis, Zlatko Fras, Dan Gaita, Nina Gotcheva, John Goudevenos, Peter Heuschmann, Aleksandras Laucevicius, Seppo Lehto, Dragan Lovic, Davor Milicic, David Moore, Evagoras Nicolaides, Raphae Oganov, Andrzej Pajak, Nana Pogosova, Zeljko Reiner, Martin Stagmo, Stefan Störk, Lale Tokgözoglu, Dusko Vulic
URN:urn:nbn:de:bvb:20-opus-141358
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für Klinische Epidemiologie und Biometrie
Language:English
Parent Title (English):Cardiovascular Diabetology
Year of Completion:2015
Volume:14
Issue:133
Source:Cardiovascular Diabetology (2015) 14:133 DOI 10.1186/s12933-015-0296-y
DOI:https://doi.org/10.1186/s12933-015-0296-y
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:blood lipids; blood pressure; blood-glucose; cardiovascular diseases; coronary artery disease; follow-up; glucose control; glycaemic control; guideline adherence; guidelines; heart; management; mellitus; mortality; myocardial infarction; risk factors; secondary prevention; type 2 diabetes
Release Date:2016/12/16
Contributing Corporation:EUROASPIRE Investigators
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung