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Eur J Prev Cardiol. 2015 Jun;22(6):753-61. doi: 10.1177/2047487314529353. Epub 2014 Apr 1.

Does pharmacologic treatment in patients with established coronary artery disease and diabetes fulfil guideline recommended targets? A report from the EUROASPIRE III cross-sectional study.

Author information

1
Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Sweden Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden vivecagyberg@gmail.com.
2
Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, UK.
3
Laboratoire d'Épidémiologie et de Santé Publique, Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, France.
4
Department of Public Health, Ghent University, Belgium.
5
Cardiology Unit, Department of Medicine Solna, Karolinska Institutet, Sweden.

Abstract

PURPOSE:

The aim was to investigate the use of cardioprotective drug therapies (aspirin or other antiplatelet agents, β-blockade, renin-angiotensin-aldosterone-system-blockade (RAAS-blockade) and statins) and treatment targets achieved in a large cohort of patients with established coronary artery disease and diabetes across Europe.

METHODS AND RESULTS:

EUROASPIRE III is an observational cross-sectional study of stable coronary artery disease patients aged 18-80 years from 76 centres in 22 European countries conducted in 2006-2007. The glycaemic status (prevalent, incident or no diabetes), the guideline treatment targets achieved and the use of pharmacotherapies were assessed at one visit 6-36 months after the index event. Of all 6588 patients investigated (women 25%), 4295 (65%) had no diabetes, 752 (11%) had incident diabetes and 1541 (23%) had prevalent diabetes. All four drugs were used in 44% of the patients with no diabetes, 51% with incident diabetes and 50% with prevalent diabetes respectively. Individual prescriptions for patients with no, incident and prevalent diabetes were respectively: aspirin or other antiplatelet agents 91, 93, and 91%; β-blockers: 81, 84, and 79%; RAAS-blockers: 77, 76, and 68%; statins: 80, 80, and 79%. The proportion of patients with coronary artery disease and prevalent diabetes reaching the treatment targets were 20% for blood pressure, 53% for low density lipoprotein cholesterol (LDL-cholesterol) and 22% for haemoglobin A1c (HbA1c).

CONCLUSION:

This European study demonstrates a low use of cardioprotective drug therapies among patients with a combination of coronary artery disease and diabetes, which will be contributing to the poor achievement of risk factor treatment targets for cardiovascular prevention.

KEYWORDS:

Cardiovascular disease; EUROASPIRE; diabetes mellitus; secondary prevention

PMID:
24691153
DOI:
10.1177/2047487314529353
[Indexed for MEDLINE]
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