OBJECTIVE: To investigate the diagnostic and therapeutic strategies applied to patients currently treated for coronary artery disease (CAD) in relation to the presence of diabetes mellitus (DM). BACKGROUND: Despite the declining mortality related to CAD, patients with DM have not experienced similar benefits and still have a deleterious prognosis compared to their non-DM counterparts. METHODS: The Euro Heart Survey on Diabetes and the Heart was conducted between February 2003 and January 2004 in 110 centres across 25 countries. Consecutive patients were recruited while referred to a cardiologist due to CAD, when admitted to hospital wards or visiting outpatient clinics. DM was defined as a diagnosis established before enrollment. RESULTS: DM was reported in 1524 (31%) of 4961 patients enrolled. Among the 1872 patients with acute coronary syndrome (ACS), adjusting for differences in clinical characteristics at baseline, DM status did not influence the propensity to use different pharmacological agents (except renin-angiotensin-aldosterone system blockers) or coronary interventions. In patients with stable CAD (n=2854) secondary prevention guidelines were poorly adhered to: 30% achieved blood pressure targets (<140/90 mmHg), and lipid control was adequate in a minority of DM and non-DM patients (total cholesterol >5 mmol/l: 55 versus 47%; low-density lipoprotein cholesterol >3 mmol/l: 57 versus 51%). CONCLUSIONS: Differences in the treatment and intervention patterns of patients with ACS disappear when corrected for the clinical confounders detected. Despite the recommendations and the high cardiovascular risk, an inadequate and less aggressive management was demonstrated in the contemporary patients with diabetes and stable CAD compared with the non-diabetic counterparts.
OBJECTIVE: To investigate the diagnostic and therapeutic strategies applied to patients currently treated for coronary artery disease (CAD) in relation to the presence of diabetes mellitus (DM). BACKGROUND: Despite the declining mortality related to CAD, patients with DM have not experienced similar benefits and still have a deleterious prognosis compared to their non-DM counterparts. METHODS: The Euro Heart Survey on Diabetes and the Heart was conducted between February 2003 and January 2004 in 110 centres across 25 countries. Consecutive patients were recruited while referred to a cardiologist due to CAD, when admitted to hospital wards or visiting outpatient clinics. DM was defined as a diagnosis established before enrollment. RESULTS:DM was reported in 1524 (31%) of 4961 patients enrolled. Among the 1872 patients with acute coronary syndrome (ACS), adjusting for differences in clinical characteristics at baseline, DM status did not influence the propensity to use different pharmacological agents (except renin-angiotensin-aldosterone system blockers) or coronary interventions. In patients with stable CAD (n=2854) secondary prevention guidelines were poorly adhered to: 30% achieved blood pressure targets (<140/90 mmHg), and lipid control was adequate in a minority of DM and non-DMpatients (total cholesterol >5 mmol/l: 55 versus 47%; low-density lipoprotein cholesterol >3 mmol/l: 57 versus 51%). CONCLUSIONS: Differences in the treatment and intervention patterns of patients with ACS disappear when corrected for the clinical confounders detected. Despite the recommendations and the high cardiovascular risk, an inadequate and less aggressive management was demonstrated in the contemporary patients with diabetes and stable CAD compared with the non-diabetic counterparts.
Authors: Neha J Pagidipati; Ann Marie Navar; Karen S Pieper; Jennifer B Green; M Angelyn Bethel; Paul W Armstrong; Robert G Josse; Darren K McGuire; Yuliya Lokhnygina; Jan H Cornel; Sigrun Halvorsen; Timo E Strandberg; Tuncay Delibasi; Rury R Holman; Eric D Peterson Journal: Circulation Date: 2017-06-16 Impact factor: 29.690
Authors: Viveca Gyberg; Dirk De Bacquer; Guy De Backer; Catriona Jennings; Kornelia Kotseva; Linda Mellbin; Oliver Schnell; Jaakko Tuomilehto; David Wood; Lars Rydén; 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 Miličić; David Moore; Evagoras Nicolaides; Raphael Oganov; Andrzej Pająk; Nana Pogosova; Zeljko Reiner; Martin Stagmo; Stefan Störk; Lale Tokgözoğlu; Dusko Vulic Journal: Cardiovasc Diabetol Date: 2015-10-01 Impact factor: 9.951
Authors: Barbara Bohn; Christof Schöfl; Vincent Zimmer; Michael Hummel; Nikolai Heise; Erhard Siegel; Wolfram Karges; Michaela Riedl; Reinhard W Holl Journal: Cardiovasc Diabetol Date: 2016-05-03 Impact factor: 9.951