Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study

Jean Ferrières, Dominik Lautsch, Baishali M. Ambegaonkar, Gaetano M. De Ferrari, Ami Vyas, Carl A. Baxter, Lori D. Bash, Maja Velkovski-Rouyer, Martin Horack, Wael Almahmeed, Fu Tien Chiang, Kian Keong Poh, Moses Elisaf, Philippe Brudi, Anselm K. Gitt

Research output: Contribution to journalArticle

Abstract

Background: Guidelines recommend lifestyle modification and medications to control risk factors in coronary heart disease (CHD). Using data from the observational DYSIS II study, we sought to evaluate the use of guideline-recommended treatments at discharge for acute coronary syndromes (ACS) or in the chronic phase for CHD, and participation in rehabilitation/secondary prevention programs. Methods and results: Between 2013 and 2014, 10,661 patients (3867 with ACS, 6794 with stable CHD) were enrolled in 332 primary and secondary care centers in 18 countries (Asia, Europe, Middle East). Patients with incident ACS were younger and more likely to be smokers than patients with recurrent ACS or stable CHD (both p < 0.0001). Sedentary lifestyle was common (44.4% of ACS patients; 44.2% of stable CHD patients); 22.8% of ACS patients and 24.3% of stable CHD patients were obese. Prevalence of low high-density lipoprotein cholesterol (<40 mg/dL in men/50 mg/dL in women) was 46.9% in chronic CHD and 55.0% in ACS. Rates of secondary prevention medications were lower among CHD versus ACS (all p < 0.0001): antiplatelet 94.3% vs 98.0%, beta-blocker 72.0% vs 80.0%, lipid-lowering therapy 94.7 vs 97.5%, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers 69.4% vs 73.7%, respectively. Attendance at cardiac rehabilitation (16.8% of patients with a first ACS, 10.8% with recurrent ACS) or a secondary prevention program (3.7% of ACS and 11.7% of stable CHD patients) was infrequent. Conclusions: The high prevalence of risk factors in all CHD patients and reduced rates of secondary prevention medications in stable CHD offer areas for improvement. Translational aspects: The findings of DYSIS II may reinforce the importance of adopting a healthy lifestyle and prescribing (by clinicians) and adhering (by patients) to evidence-based medications in the management of CHD, not only during the short term but also over the longer term after a cardiac ischemic event. The results may help to increase the proportion of ACS patients who are referred to cardiac rehabilitation centres.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Acute Coronary Syndrome
Coronary Disease
Guidelines
Secondary Prevention
Secondary Care Centers
Sedentary Lifestyle
Rehabilitation Centers
Middle East
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
LDL Cholesterol
HDL Cholesterol
Life Style
Primary Health Care
Rehabilitation
Lipids

Keywords

  • Cardiovascular diseases
  • Coronary disease
  • Evidence-based therapy
  • Guideline adherence
  • Secondary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study. / Ferrières, Jean; Lautsch, Dominik; Ambegaonkar, Baishali M.; De Ferrari, Gaetano M.; Vyas, Ami; Baxter, Carl A.; Bash, Lori D.; Velkovski-Rouyer, Maja; Horack, Martin; Almahmeed, Wael; Chiang, Fu Tien; Poh, Kian Keong; Elisaf, Moses; Brudi, Philippe; Gitt, Anselm K.

In: International Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

Ferrières, J, Lautsch, D, Ambegaonkar, BM, De Ferrari, GM, Vyas, A, Baxter, CA, Bash, LD, Velkovski-Rouyer, M, Horack, M, Almahmeed, W, Chiang, FT, Poh, KK, Elisaf, M, Brudi, P & Gitt, AK 2018, 'Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study', International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2018.06.008
Ferrières, Jean ; Lautsch, Dominik ; Ambegaonkar, Baishali M. ; De Ferrari, Gaetano M. ; Vyas, Ami ; Baxter, Carl A. ; Bash, Lori D. ; Velkovski-Rouyer, Maja ; Horack, Martin ; Almahmeed, Wael ; Chiang, Fu Tien ; Poh, Kian Keong ; Elisaf, Moses ; Brudi, Philippe ; Gitt, Anselm K. / Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study. In: International Journal of Cardiology. 2018.
@article{ab4eb9a505df48fea450176f90d1a297,
title = "Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study",
abstract = "Background: Guidelines recommend lifestyle modification and medications to control risk factors in coronary heart disease (CHD). Using data from the observational DYSIS II study, we sought to evaluate the use of guideline-recommended treatments at discharge for acute coronary syndromes (ACS) or in the chronic phase for CHD, and participation in rehabilitation/secondary prevention programs. Methods and results: Between 2013 and 2014, 10,661 patients (3867 with ACS, 6794 with stable CHD) were enrolled in 332 primary and secondary care centers in 18 countries (Asia, Europe, Middle East). Patients with incident ACS were younger and more likely to be smokers than patients with recurrent ACS or stable CHD (both p < 0.0001). Sedentary lifestyle was common (44.4{\%} of ACS patients; 44.2{\%} of stable CHD patients); 22.8{\%} of ACS patients and 24.3{\%} of stable CHD patients were obese. Prevalence of low high-density lipoprotein cholesterol (<40 mg/dL in men/50 mg/dL in women) was 46.9{\%} in chronic CHD and 55.0{\%} in ACS. Rates of secondary prevention medications were lower among CHD versus ACS (all p < 0.0001): antiplatelet 94.3{\%} vs 98.0{\%}, beta-blocker 72.0{\%} vs 80.0{\%}, lipid-lowering therapy 94.7 vs 97.5{\%}, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers 69.4{\%} vs 73.7{\%}, respectively. Attendance at cardiac rehabilitation (16.8{\%} of patients with a first ACS, 10.8{\%} with recurrent ACS) or a secondary prevention program (3.7{\%} of ACS and 11.7{\%} of stable CHD patients) was infrequent. Conclusions: The high prevalence of risk factors in all CHD patients and reduced rates of secondary prevention medications in stable CHD offer areas for improvement. Translational aspects: The findings of DYSIS II may reinforce the importance of adopting a healthy lifestyle and prescribing (by clinicians) and adhering (by patients) to evidence-based medications in the management of CHD, not only during the short term but also over the longer term after a cardiac ischemic event. The results may help to increase the proportion of ACS patients who are referred to cardiac rehabilitation centres.",
keywords = "Cardiovascular diseases, Coronary disease, Evidence-based therapy, Guideline adherence, Secondary prevention",
author = "Jean Ferri{\`e}res and Dominik Lautsch and Ambegaonkar, {Baishali M.} and {De Ferrari}, {Gaetano M.} and Ami Vyas and Baxter, {Carl A.} and Bash, {Lori D.} and Maja Velkovski-Rouyer and Martin Horack and Wael Almahmeed and Chiang, {Fu Tien} and Poh, {Kian Keong} and Moses Elisaf and Philippe Brudi and Gitt, {Anselm K.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ijcard.2018.06.008",
language = "English",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Use of guideline-recommended management in established coronary heart disease in the observational DYSIS II study

AU - Ferrières, Jean

AU - Lautsch, Dominik

AU - Ambegaonkar, Baishali M.

AU - De Ferrari, Gaetano M.

AU - Vyas, Ami

AU - Baxter, Carl A.

AU - Bash, Lori D.

AU - Velkovski-Rouyer, Maja

AU - Horack, Martin

AU - Almahmeed, Wael

AU - Chiang, Fu Tien

AU - Poh, Kian Keong

AU - Elisaf, Moses

AU - Brudi, Philippe

AU - Gitt, Anselm K.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Guidelines recommend lifestyle modification and medications to control risk factors in coronary heart disease (CHD). Using data from the observational DYSIS II study, we sought to evaluate the use of guideline-recommended treatments at discharge for acute coronary syndromes (ACS) or in the chronic phase for CHD, and participation in rehabilitation/secondary prevention programs. Methods and results: Between 2013 and 2014, 10,661 patients (3867 with ACS, 6794 with stable CHD) were enrolled in 332 primary and secondary care centers in 18 countries (Asia, Europe, Middle East). Patients with incident ACS were younger and more likely to be smokers than patients with recurrent ACS or stable CHD (both p < 0.0001). Sedentary lifestyle was common (44.4% of ACS patients; 44.2% of stable CHD patients); 22.8% of ACS patients and 24.3% of stable CHD patients were obese. Prevalence of low high-density lipoprotein cholesterol (<40 mg/dL in men/50 mg/dL in women) was 46.9% in chronic CHD and 55.0% in ACS. Rates of secondary prevention medications were lower among CHD versus ACS (all p < 0.0001): antiplatelet 94.3% vs 98.0%, beta-blocker 72.0% vs 80.0%, lipid-lowering therapy 94.7 vs 97.5%, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers 69.4% vs 73.7%, respectively. Attendance at cardiac rehabilitation (16.8% of patients with a first ACS, 10.8% with recurrent ACS) or a secondary prevention program (3.7% of ACS and 11.7% of stable CHD patients) was infrequent. Conclusions: The high prevalence of risk factors in all CHD patients and reduced rates of secondary prevention medications in stable CHD offer areas for improvement. Translational aspects: The findings of DYSIS II may reinforce the importance of adopting a healthy lifestyle and prescribing (by clinicians) and adhering (by patients) to evidence-based medications in the management of CHD, not only during the short term but also over the longer term after a cardiac ischemic event. The results may help to increase the proportion of ACS patients who are referred to cardiac rehabilitation centres.

AB - Background: Guidelines recommend lifestyle modification and medications to control risk factors in coronary heart disease (CHD). Using data from the observational DYSIS II study, we sought to evaluate the use of guideline-recommended treatments at discharge for acute coronary syndromes (ACS) or in the chronic phase for CHD, and participation in rehabilitation/secondary prevention programs. Methods and results: Between 2013 and 2014, 10,661 patients (3867 with ACS, 6794 with stable CHD) were enrolled in 332 primary and secondary care centers in 18 countries (Asia, Europe, Middle East). Patients with incident ACS were younger and more likely to be smokers than patients with recurrent ACS or stable CHD (both p < 0.0001). Sedentary lifestyle was common (44.4% of ACS patients; 44.2% of stable CHD patients); 22.8% of ACS patients and 24.3% of stable CHD patients were obese. Prevalence of low high-density lipoprotein cholesterol (<40 mg/dL in men/50 mg/dL in women) was 46.9% in chronic CHD and 55.0% in ACS. Rates of secondary prevention medications were lower among CHD versus ACS (all p < 0.0001): antiplatelet 94.3% vs 98.0%, beta-blocker 72.0% vs 80.0%, lipid-lowering therapy 94.7 vs 97.5%, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers 69.4% vs 73.7%, respectively. Attendance at cardiac rehabilitation (16.8% of patients with a first ACS, 10.8% with recurrent ACS) or a secondary prevention program (3.7% of ACS and 11.7% of stable CHD patients) was infrequent. Conclusions: The high prevalence of risk factors in all CHD patients and reduced rates of secondary prevention medications in stable CHD offer areas for improvement. Translational aspects: The findings of DYSIS II may reinforce the importance of adopting a healthy lifestyle and prescribing (by clinicians) and adhering (by patients) to evidence-based medications in the management of CHD, not only during the short term but also over the longer term after a cardiac ischemic event. The results may help to increase the proportion of ACS patients who are referred to cardiac rehabilitation centres.

KW - Cardiovascular diseases

KW - Coronary disease

KW - Evidence-based therapy

KW - Guideline adherence

KW - Secondary prevention

UR - http://www.scopus.com/inward/record.url?scp=85048701907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048701907&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2018.06.008

DO - 10.1016/j.ijcard.2018.06.008

M3 - Article

AN - SCOPUS:85048701907

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -