4.6 Article

Profile and treatment of chronic coronary syndromes in European Society of Cardiology member countries The ESC EORP CICD-LT registry

Journal

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
Volume 28, Issue 4, Pages 432-445

Publisher

OXFORD UNIV PRESS
DOI: 10.1177/2047487320912491

Keywords

Chronic coronary syndromes; cohort; management; prevention

Funding

  1. Abbott Vascular Int.
  2. Amgen Cardiovascular
  3. AstraZeneca
  4. Bayer
  5. Boehringer Ingelheim
  6. Boston Scientific
  7. Bristol Myers Squibb and Pfizer Alliance
  8. Alliance Daiichi Sankyo Europe GmbH
  9. Eli Lilly and Company
  10. Edwards
  11. Gedeon Richter Plc.
  12. Menarini Int. Op.
  13. MSD-Merck Co.
  14. Novartis Pharma AG
  15. ResMed
  16. Sanofi
  17. SERVIER
  18. Vifor

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The CICD-LT registry is investigating outcomes and management in CCS patients in ESC member countries, finding common cardiovascular risk factors and suboptimal prescribing. Older and female patients were less likely to receive guideline-recommended drug combinations.
Background International guidelines recommend pharmacotherapy combinations for chronic coronary syndromes (CCSs) but medical management remains suboptimal. Design The CICD-LT registry is investigating short- and long-term outcomes and management in patients in European Society of Cardiology (ESC) member countries, in a longitudinal ESC EURObservational Research Programme aimed at improving CCS management. Methods Between 1 May 2015 and 31 July 2018, 9174 patients with previous ST-elevation myocardial infarction (STEMI), non-STEMI or coronary revascularisation, or other CCS, were recruited during a routine ambulatory visit or elective revascularisation procedure. Baseline clinical data were recorded and prescribed medications analysed at initial contact and discharge, and according to patient gender and age (vs. >= 75 years). Results Poorly controlled cardiovascular risk factors, including current smoking (18.5%), obesity (33.9%), diabetes (25.8%), raised low-density lipoprotein cholesterol (73.3%) and persistent hypertension (24.7%), were common across all cohorts. At ambulatory visit or admission, the guidelines-recommended combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, aspirin, statin and any antiplatelet agent was prescribed to 57.8% of patients with STEMI/NSTEMI. Differences in prescribing rates, including for combination therapies, were observed based on age and gender and persisted after adjustment for demographic factors. Conclusions Cardiovascular risk factors were common in contemporary CCS patients and secondary prevention prescribing was suboptimal. Patients aged >= 75 years and, to some extent, female patients were less likely to receive guidelines-recommended drug combinations than younger and male patients. One- and two-year follow-up will study prescribing changes and associations between baseline characteristics/prescribing and subsequent clinical outcomes.

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