Current management and treatment of patients with stable coronary artery diseases presenting to cardiologists in different clinical contexts: A prospective, observational, nationwide study
- 10 November 2017
- journal article
- research article
- Published by Oxford University Press (OUP) in European Journal of Preventive Cardiology
- Vol. 25 (1), 43-53
- https://doi.org/10.1177/2047487317740663
Abstract
Stable coronary artery disease (CAD) is a leading cause of mortality worldwide. Few studies document the complete sequence of investigation of the overall stable CAD population during outpatient visits or hospitalisation. To obtain accurate and up-to-date information on current management of patients with stable CAD. START (STable coronary Artery diseases RegisTry) was a prospective, observational, nationwide study aimed at evaluating the presentation, management, treatment and quality of life of stable CAD patients presenting to cardiologists during outpatient visits or discharged from cardiology wards. Over a 3-month period, 5070 consecutive patients were enrolled in 183 participating centres: 72% managed by a cardiologist during outpatient or day hospital visits and 28% discharged from cardiology wards. The vast majority of patients (87%) received a coronary angiography (86% of patients managed during outpatient visits and 90% during hospitalisation; p < 0.0001). Outpatients more frequently received optimal medical therapy (OMT; i.e. aspirin or thienopyridine, β-blockers and statins) compared to hospitalised patients (70.2% vs 67.1%; p = 0.03). A personalised diet was prescribed in 58% (60.5% in outpatients and 52.9% in those admitted to hospitals; p < 0.0001), physical activity programmes were suggested in 65% (69.4% and 54.3%; p < 0.0001) and smoking cessation was recommended in 71% of currently smoking patients (73.2% and 65.2%; p = 0.02). In this large, contemporary registry, patients with stable CAD discharged from cardiology wards more commonly underwent diagnostic imaging procedures and less frequently received OMT or lifestyle modification programmes compared to patients manged by cardiologists during outpatient visits.This publication has 30 references indexed in Scilit:
- Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)Quality of Life Research, 2011
- Patients' and Cardiologists' Perceptions of the Benefits of Percutaneous Coronary Intervention for Stable Coronary DiseaseAnnals of Internal Medicine, 2010
- Optimal Medical Therapy With or Without Percutaneous Coronary Intervention in Older Patients With Stable Coronary Disease: A Pre-Specified Subset Analysis of the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive druG Evaluation) TrialJournal of the American College of Cardiology, 2009
- Optimal Medical Therapy Is a Proven Option for Chronic Stable AnginaJournal of the American College of Cardiology, 2008
- Optimal Medical Therapy with or without PCI for Stable Coronary DiseaseThe New England Journal of Medicine, 2007
- Percutaneous Coronary Intervention Versus Conservative Therapy in Nonacute Coronary Artery DiseaseCirculation, 2005
- The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable AnginaEuropean Heart Journal, 2005
- The initial management of stable angina in Europe, from the Euro Heart SurveyEuropean Heart Journal, 2005
- History of depression, angina, and quality of life after acute coronary syndromesAmerican Heart Journal, 2003
- Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndromeEuropean Heart Journal, 2000