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.

Gyberg, Viveca and De Bacquer, Dirk and De Backer, Guy and Jennings, Catriona and Kotseva, Kornelia and Mellbin, Linda and Schnell, Oliver and Tuomilehto, Jaakko and Wood, David and Rydén, Lars and Amouyel, Philippe and Bruthans, Jan and Conde, Almudena Castro and Cifkova, Renata and Deckers, Jaap W. and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Maryna and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Goudevenos, John and Heuschmann, Peter and Laucevicius, Aleksandras and Lehto, Seppo and Lovic, Dragan and Miličić, Davor and Moore, David and Nicolaides, Evagoras and Oganov, Raphael and Pająk, Andrzej and Pogosova, Nana and Reiner, Željko and Stagmo, Martin and Störk, Stefan and Tokgözoğlu, Lale and Vulic, Dusko (2015) 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. Cardiovascular Diabetology, 14. p. 133. ISSN 1475-2840

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Abstract

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 (≈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.

Item Type: Article
Additional Information: © 2015 Gyberg et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0) applies to the data made available in this article, unless otherwise stated.
MeSH: Adrenergic beta-Antagonists/therapeutic use ; Aged ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Antihypertensive Agents/therapeutic use ; Blood Pressure ; Cardiotonic Agents/therapeutic use ; Cholesterol, LDL/metabolism ; Coronary Artery Disease/complications ; Coronary Artery Disease/drug therapy ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Dyslipidemias/complications ; Dyslipidemias/drug therapy ; Dyslipidemias/metabolism ; Europe ; Female ; Guideline Adherence ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypertension/complications ; Hypertension/drug therapy ; Hypoglycemic Agents/therapeutic use ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/therapeutic use ; Practice Guidelines as Topic ; Registries ; Risk Factors ; Secondary Prevention
Departments: Katedra za internu medicinu
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Gyberg, VivecaUNSPECIFIED
De Bacquer, DirkUNSPECIFIED
De Backer, GuyUNSPECIFIED
Jennings, CatrionaUNSPECIFIED
Kotseva, KorneliaUNSPECIFIED
Mellbin, LindaUNSPECIFIED
Schnell, OliverUNSPECIFIED
Tuomilehto, JaakkoUNSPECIFIED
Wood, DavidUNSPECIFIED
Rydén, LarsUNSPECIFIED
Amouyel, PhilippeUNSPECIFIED
Bruthans, JanUNSPECIFIED
Conde, Almudena CastroUNSPECIFIED
Cifkova, RenataUNSPECIFIED
Deckers, Jaap W.UNSPECIFIED
De Sutter, JohanUNSPECIFIED
Dilic, MirzaUNSPECIFIED
Dolzhenko, MarynaUNSPECIFIED
Erglis, AndrejsUNSPECIFIED
Fras, ZlatkoUNSPECIFIED
Gaita, DanUNSPECIFIED
Gotcheva, NinaUNSPECIFIED
Goudevenos, JohnUNSPECIFIED
Heuschmann, PeterUNSPECIFIED
Laucevicius, AleksandrasUNSPECIFIED
Lehto, SeppoUNSPECIFIED
Lovic, DraganUNSPECIFIED
Miličić, DavorUNSPECIFIED
Moore, DavidUNSPECIFIED
Nicolaides, EvagorasUNSPECIFIED
Oganov, RaphaelUNSPECIFIED
Pająk, AndrzejUNSPECIFIED
Pogosova, NanaUNSPECIFIED
Reiner, ŽeljkoUNSPECIFIED
Stagmo, MartinUNSPECIFIED
Störk, StefanUNSPECIFIED
Tokgözoğlu, LaleUNSPECIFIED
Vulic, DuskoUNSPECIFIED
Date: 1 October 2015
Date Deposited: 09 Aug 2016 10:33
Last Modified: 09 Aug 2016 10:33
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2621

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