Nearly 25 percent of chronic ischemic heart disease patients dead or hospitalized in six months

January 17, 2018, European Society of Cardiology

Nearly a quarter of patients with chronic ischaemic cardiovascular disease are dead or hospitalised within six months, reports a European Society of Cardiology (ESC) study published today in the European Journal of Preventive Cardiology.

"Coronary artery is the leading cause of death worldwide yet some appear to get lost in the system after their initial visit to a hospital or outpatient clinic," said lead author Cardiology Professor Michel Komajda, of the University Pierre and Marie Curie and Pitié-Salpêtrière Hospital in Paris, France.

The Chronic Ischaemic Cardiovascular Disease (CICD) Pilot Registry was designed to learn what happens to these patients in the six months after being seen by a health professional. The observational study was conducted as part of the EURObservational Research Programme (EORP) of the ESC.

The study included 2,420 patients from 100 hospitals and outpatient clinics in ten European countries. Participants had stable coronary disease2 or , the most common conditions seen by a cardiologist. Risk factors and treatments were recorded at the start of the study and have been previously reported.3 Treatments and outcomes were recorded at six months.

Follow-up data were available for 2,203 patients, of whom 522 (24%) had died or been rehospitalised during the six months. Factors significantly associated with the risk of dying or being rehospitalised were older age, with a hazard ratio (HR) of 1.17 for every ten years, history of peripheral revascularisation (HR 1.45), (HR 1.31) and chronic (HR 1.42) (all p<0.05). The majority of the causes of death and rehospitalisation were cardiovascular.

Professor Komajda said: "These patients are at high risk of dying or being rehospitalised in the short-term and should be carefully monitored by physicians. We identified clinical factors which are strongly associated with this high risk which can easily be assessed."

The rate of prescription of angiotensin converting enzyme inhibitors, beta-blockers (both drugs reduce blood pressure) and aspirin was lower at six months compared to the start of the study (all p<0.02).

Professor Komajda said: "In absolute numbers the reductions were modest but they did reach statistical significance. This shows that patients have a better chance of receiving recommended medications while in hospital or directly after an outpatient appointment. Six months later, drugs they should be taking to reduce the risk of death and rehospitalisation are prescribed less frequently."

He added: "It is likely that there is insufficient handover of these patients to a cardiologist or GP and so their prescriptions are not renewed."

While the study did not assess the reasons for the reduction in prescriptions, possible factors include: patients getting tired of taking pills or cannot afford them.

Six month rates of death and rehospitalisation were significantly higher in eastern, western and northern European countries compared to those in the south. Given the relatively small number of patients, Professor Komajda said firm conclusions could not be drawn. But he said: "We anticipated that outcomes would be better in Mediterranean countries and this was correct, probably because of the diet and other lifestyle reasons."

Professor Komajda concluded: "The study shows that patients with chronic ischaemic cardiovascular disease have a high risk of poor short-term outcomes. Yet some are not receiving recommended preventive medications which could improve their outlook. More efforts are needed to ensure that these patients continue to be monitored and treated after they leave or an outpatient appointment."

Explore further: Treatment with life-saving drugs increases but still suboptimal in ischaemic heart disease

More information: 1 Komajda M, et al. The chronic ischaemic cardiovascular disease ESC Pilot Registry: Results of the six-month follow-up. European Journal of Preventive Cardiology. 2018. DOI: 10.1177/2047487317751955

2 Undergoing coronary revascularisation or not.

3 Komajda M, et al. EURObservational Research Programme: the Chronic Ischaemic Cardiovascular Disease Registry: Pilot phase (CICD-PILOT). Eur Heart J. 2016;37(2):152-160. DOI: 10.1093/eurheartj/ehv437.

Related Stories

Treatment with life-saving drugs increases but still suboptimal in ischaemic heart disease

September 1, 2015
Treatment with life-saving medications has increased over the past ten years in ischaemic heart disease but levels are still suboptimal, according to the first results of the Chronic Ischaemic Cardiovascular Disease (CICD) ...

High-risk plaque on coronary CTA linked to future MACE

January 11, 2018
(HealthDay)—For outpatients with stable chest pain, high-risk plaque found by coronary computed tomographic angiography (CTA) is associated with subsequent major adverse cardiovascular events (MACE), according to a study ...

Coronary calcium predicts heart disease risk in patients with chronic kidney disease

August 21, 2014
Calcium buildup in the coronary arteries may be a better indicator of kidney disease patients' risk of heart disease than traditional risk factors used in the general population, according to a study appearing in an upcoming ...

Male-pattern baldness and premature graying associated with risk of early heart disease

November 30, 2017
Male-pattern baldness and premature greying are associated with a more than fivefold risk of heart disease before the age of 40 years, according to research presented at the 69th Annual Conference of the Cardiological Society ...

Peripheral arterial disease: Longer duration of dual antiplatelet therapy after stent placement improves outcomes

August 30, 2016
In a study published online by JAMA Cardiology, Marco Valgimigli, M.D., Ph.D., of Bern University Hospital, Bern, Switzerland, and colleagues assessed the efficacy and safety of prolonged (24 months) vs short (6 months or ...

ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases published today

August 26, 2017
European Society of Cardiology (ESC) Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, developed in collaboration with the European Society for Vascular Surgery (ESVS), are published online today ...

Recommended for you

Beetroot juice supplements may help certain heart failure patients

February 22, 2018
Beetroot juice supplements may help enhance exercise capacity in patients with heart failure, according to a new proof-of-concept study. Exercise capacity is a key factor linked to these patients' quality of life and even ...

Heart researchers develop a new, promising imaging technique for cardiac arrhythmias

February 22, 2018
Every five minutes in Germany alone, a person dies of sudden cardiac arrest or fibrillation, the most common cause of death worldwide. This is partly due to the fact that doctors still do not fully understand exactly what ...

Scientists use color-coded tags to discover how heart cells develop

February 22, 2018
UCLA researchers used fluorescent colored proteins to trace how cardiomyocytes—cells in heart muscle that enable it to pump blood—are produced in mouse embryos. The findings could eventually lead to methods for regenerating ...

'Beetroot pill' could help save patients from kidney failure after heart X-ray

February 22, 2018
Beetroot may reduce the risk of kidney failure in patients having a heart x-ray, according to research led by Queen Mary University of London.

Women once considered low risk for heart disease show evidence of previous heart attack scars

February 20, 2018
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart ...

Can your cardiac device be hacked?

February 20, 2018
Medical devices, including cardiovascular implantable electronic devices could be at risk for hacking. In a paper publishing online today in the Journal of the American College of Cardiology, the American College of Cardiology's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.