3
|
Gyberg V, De Bacquer D, De Backer G, Jennings C, Kotseva K, Mellbin L, Schnell O, Tuomilehto J, Wood D, Rydén L, Amouyel P, Bruthans J, Conde AC, Cifkova R, Deckers JW, De Sutter J, Dilic M, Dolzhenko M, Erglis A, Fras Z, Gaita D, Gotcheva N, Goudevenos J, Heuschmann P, Laucevicius A, Lehto S, Lovic D, Miličić D, Moore D, Nicolaides E, Oganov R, Pająk A, Pogosova N, Reiner Z, Stagmo M, Störk S, Tokgözoğlu L, Vulic D. 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. Cardiovasc Diabetol 2015; 14:133. [PMID: 26427624 PMCID: PMC4591740 DOI: 10.1186/s12933-015-0296-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 09/24/2015] [Indexed: 12/14/2022] Open
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.
Collapse
Affiliation(s)
- Viveca Gyberg
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. .,Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
| | - Dirk De Bacquer
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Public Health, Ghent University, Ghent, Belgium.
| | - Guy De Backer
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Public Health, Ghent University, Ghent, Belgium.
| | - Catriona Jennings
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
| | - Kornelia Kotseva
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
| | - Linda Mellbin
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. .,European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France.
| | - Oliver Schnell
- Forschergruppe Diabetes e.V. at the Helmholtz Center, Munich, Germany.
| | - Jaakko Tuomilehto
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Centre for Vascular Prevention, Danube-University Krems, Krems, Austria. .,Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. .,Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain. .,Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - David Wood
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
| | - Lars Rydén
- Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. .,European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France.
| | - Philippe Amouyel
- Institut Pasteur de Lille, Inserm U744, Université Lille Nord de France, 1 rue du Professeur Calmette B.P. 245, 59019, Lille, France.
| | - Jan Bruthans
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Center for Cardiovascular Prevention, 1st School of Medicine, Charles University and Thomayer Hospital, Vídeňská 800, 140 59, Prague, Czech Republic.
| | - Almudena Castro Conde
- Cardiac Rehabilitation Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain.
| | - Renata Cifkova
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Center for Cardiovascular Prevention, 1st School of Medicine, Charles University and Thomayer Hospital, Vídeňská 800, 140 59, Prague, Czech Republic.
| | - Jaap W Deckers
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Thoraxcenter's Department of Cardiology, Dr Molewaterplein 50, 3000 DR, Rotterdam, The Netherlands.
| | - Johan De Sutter
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Department of Internal Medicine, University of Ghent, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Mirza Dilic
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Clinical Center University of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina.
| | - Maryna Dolzhenko
- Department of Cardiology of Shupyk's Medical Academy of Postgraduate Education, 9 Dorohozhyts'ka str, Kiev, 04112, Ukraine.
| | - Andrejs Erglis
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,University of Latvia, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, Riga, 1002, Latvia.
| | - Zlatko Fras
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Preventive Cardiology Unit, Division of Internal Medicine, University Medical Centre Ljubljana, Zaloška 7, 1525, Ljubljana, Slovenia. .,Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - Dan Gaita
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie "Victor Babes", Timisoara, Romania.
| | - Nina Gotcheva
- Department of Cardiology, National Heart Hospital, 65, Konyovitsa, 1309, Sofia, Bulgaria.
| | - John Goudevenos
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Cardiology Department of Medical School, University of Ioannina, Ioannina, Greece.
| | - Peter Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany. .,Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. .,Clinical Trial Center Würzburg, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.
| | - Aleksandras Laucevicius
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Clinic of Cardiovascular Diseases of Vilnius University, Santariskiu 2, 08661, Vilnius, Lithuania. .,Heart and Vascular Medicine of Vilnius University Hospital Santariskiu Clinics, Santariskiu 2, 08661, Vilnius, Lithuania.
| | - Seppo Lehto
- Kuopio University Hospital, Rakennus 5/6. Kerros, Puijonlaaksontie 2, 70210, Kuopio, Finland.
| | - Dragan Lovic
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Clinic for Internal Medicine Intermedica, Jovana Ristica 20/2, 18000, Nis, Serbia.
| | - Davor Miličić
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,University of Zagreb School of Medicine and University Hospital Centre Zagreb, Kispaticeva 12, HR-10000, Zagreb, Croatia.
| | - David Moore
- The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
| | - Evagoras Nicolaides
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,University of Nicosia Medical School, Nicosia General Hospital, 2029 Strovolos, Nicosia, Cyprus.
| | - Raphael Oganov
- National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, 10 Petroverigsky per, 101990, Moscow, Russia.
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jafiellonian University Medical College, Grzegórzecka 20, 31-531, Cracow, Poland.
| | - Nana Pogosova
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Federal Health Centre and Department of Chronic Noncommunicable Diseases Prevention, National Research Centre for Preventive Medicine, 10 Petroverigsky per, 101953, Moscow, Russia.
| | - Zeljko Reiner
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
| | - Martin Stagmo
- Department of Heart failure and Valve Disease, Skåne University Hospital, Lund, Sweden.
| | - Stefan Störk
- Comprehensive Heart Failure Centre and Department of Medicine I, University of Würzburg, Straubmühlweg 2a, 97078, Würzburg, Germany.
| | - Lale Tokgözoğlu
- European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. .,Hacettepe University, 06690, Ankara, Turkey.
| | - Dusko Vulic
- Centre for Medical Research, School of Medicine, University of Banja Luka, Vuka Karadzica 6, 78000, Banja Luka, Republic of Srpska, Bosnia and Herzegovina.
| | | |
Collapse
|