261 results found
Pries AR, Naoum A, Habazettl H, et al., 2018, CardioScape mapping the cardiovascular funding landscape in Europe, EUROPEAN HEART JOURNAL, Vol: 39, Pages: 2423-2430, ISSN: 0195-668X
Amadi CE, Grove TP, Mbakwem AC, et al., 2018, Prevalence of cardiometabolic risk factors among professional male long-distance bus drivers in Lagos, south-west Nigeria: a cross-sectional study, CARDIOVASCULAR JOURNAL OF AFRICA, Vol: 29, Pages: 106-114, ISSN: 1995-1892
Mittal TK, Cleghorn CL, Cade JE, et al., 2017, A cross-sectional survey of cardiovascular health and lifestyle habits of hospital staff in the UK: Do we look after ourselves?, European Journal of Preventive Cardiology, Vol: 25, Pages: 543-550, ISSN: 2047-4873
Background A high prevalence of stress-related disorders is well known among healthcare professionals. We set out to assess the prevalence of cardiovascular risk factors and compliance with national dietary and physical activity recommendations in NHS staff in the UK with comparison between clinical and non-clinical staff, and national surveys. Design A multi-centre cross-sectional study. Methods A web-based questionnaire was developed to include anonymised data on demographics, job role, cardiovascular risk factors and diseases, dietary habits, physical activity and barriers towards healthy lifestyle. This was distributed to staff in four NHS hospitals via emails. Results A total of 1158 staff completed the survey (response rate 13%) with equal distribution between the clinical and non-clinical groups. Most staff were aged 26-60 years and 79% were women. Half of the staff were either overweight or obese (51%) with no difference between the groups ( P = 0.176), but there was a lower prevalence of cardiovascular risk factors compared to the general population. The survey revealed a low compliance (17%) with the recommended intake of five-a-day portions of fruit and vegetables, and that of moderate or vigorous physical activity (56%), with no difference between the clinical and non-clinical staff ( P = 0.6). However, more clinical staff were exceeding the alcohol recommendations ( P = 0.02). Lack of fitness facilities and managerial support, coupled with long working hours, were the main reported barriers to a healthy lifestyle. Conclusions In this survey of UK NHS staff, half were found to be overweight or obese with a lower prevalence of cardiovascular risk factors compared to the general population. There was a low compliance with the five-a-day fruit and vegetables recommendation and physical activity guidelines, with no difference between the clinical and non-clinical staff.
Wood DA, Eisele J-L, 2017, Condemning industry attempts to subvert public policy for a tobacco-free world, The Lancet, ISSN: 0140-6736
Shahim B, De Bacquer D, De Backer G, et al., 2017, The Prognostic Value of Fasting Plasma Glucose, Two-Hour Postload Glucose, and HbA 1c in Patients With Coronary Artery Disease: A Report From EUROASPIRE IV, Diabetes Care, Vol: 40, Pages: 1233-1240, ISSN: 0149-5992
OBJECTIVE Three tests are recommended for identifying dysglycemia: fasting glucose (FPG), 2-h postload glucose (2h-PG) from an oral glucose tolerance test (OGTT), and glycated hemoglobin A1c (HbA1c). This study explored the prognostic value of these screening tests in patients with coronary artery disease (CAD).RESEARCH DESIGN AND METHODS FPG, 2h-PG, and HbA1c were used to screen 4,004 CAD patients without a history of diabetes (age 18–80 years) for dysglycemia. The prognostic value of these tests was studied after 2 years of follow-up. The primary end point included cardiovascular mortality, nonfatal myocardial infarction, stroke, or hospitalization for heart failure and a secondary end point of incident diabetes.RESULTS Complete information including all three glycemic parameters was available in 3,775 patients (94.3%), of whom 246 (6.5%) experienced the primary end point. Neither FPG nor HbA1c predicted the primary outcome, whereas the 2h-PG, dichotomized as <7.8 vs. ≥7.8 mmol/L, was a significant predictor (hazard ratio 1.38, 95% CI 1.07–1.78; P = 0.01). During follow-up, diabetes developed in 78 of the 2,609 patients (3.0%) without diabetes at baseline. An FPG between 6.1 and 6.9 mmol/L did not predict incident diabetes, whereas HbA1c 5.7–6.5% and 2h-PG 7.8–11.0 mmol/L were both significant independent predictors.CONCLUSIONS The 2h-PG, in contrast to FPG and HbA1c, provides significant prognostic information regarding cardiovascular events in patients with CAD. Furthermore, elevated 2h-PG and HbA1c are significant prognostic indicators of an increased risk of incident diabetes.
Wagner M, Wanner C, Kotseva K, et al., 2017, Prevalence of chronic kidney disease and its determinants in coronary heart disease patients in 24 European countries: Insights from the EUROASPIRE IV survey of the European Society of Cardiology, European Journal of Preventive Cardiology, Vol: 24, Pages: 1168-1180, ISSN: 2047-4873
AimsChronic kidney disease (CKD) is associated with the development and progression of coronary heart disease (CHD), in addition to classic cardiovascular risk factors. We analysed the prevalence of CKD in CHD patients from 24 European countries in the ambulatory setting and in a preceding hospital stay for CHD (index).Methods and resultsA total of 7998 EUROASPIRE IV participants (median 65 years of age, 76% male) attended a study visit 6–36 months after the index hospitalisation. CKD was classified according to stages of estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin/creatinine ratio). In stable CHD conditions (study visit), 17.3% had CKD (eGFR <60 mL/min/1.73 m2) with variation among participating countries (range 13.1–26.4%). A further 12% presented with preserved eGFR but significant albuminuria. During the hospital stay due to a coronary event, impaired kidney function was observed in 17.6% (range 7.5–38.2%). Risk factors for impaired kidney function included older age, female gender, classic cardiovascular (CV) risk factors, details of CHD history and congestive heart failure (multivariate regression). Of all patients, 38.9% had declined, 31.3% were stable and 29.8% had improved kidney function between hospital discharge and the study visit, dependent on age, gender, CV risk factors, CHD history and cardiac dysfunction (multivariate regression).ConclusionsEvery fifth CHD patient had CKD, while every tenth exhibited albuminuria as the sole indicator of kidney damage. These subjects are at increased risk of progression of CKD and CHD complications. After hospital stays due to CHD, there is potential of recovery of kidney function, but our findings underline the importance of identifying patients who are at high risk of developing CKD in order to counteract disease progression.
Morbach C, Wagner M, Guntner S, et al., 2017, Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation – Results from the German EuroAspire IV cohort, BMC Cardiovascular Disorders, Vol: 17, ISSN: 1471-2261
Background: Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of majorprognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aimwas to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assessthe adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for theoptimization of guideline implementation.Methods: Patients from the German sample of the European Action on Secondary and Primary Prevention byIntervention to Reduce Events (EuroAspire) IV survey with a hospitalization for CHD within the previous six to36 months providing valid data on echocardiography as well as on signs and symptoms of HF were categorizedinto stages of HF: A, prevalence of risk factors for developing HF; B, asymptomatic but with structural heart disease;C, symptomatic HF. A Guideline Adherence Indicator (GAI-3) was calculated for patients with reduced (≤40%) leftventricular ejection fraction (HFrEF) as number of drugs taken per number of drugs indicated; beta-blockers,angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and mineralocorticoid receptor antagonists(MRA) were considered.Results: 509/536 patients entered analysis. HF stage A was prevalent in n = 20 (3.9%), stage B in n = 264 (51.9%),and stage C in n = 225 (44.2%) patients; 94/225 patients were diagnosed with HFrEF (42%). Stage C patients wereolder, had a longer duration of CHD, and a higher prevalence of arterial hypertension. Awareness of pre-diagnosedHF was low (19%). Overall GAI-3 of HFrEF patients was 96.4% with a trend towards lower GAI-3 in patients withlower LVEF due to less thorough MRA prescription.Conclusions: In our sample of CHD patients, prevalence of HF stage C was high and a sizable subgroup sufferedfrom HFrEF. Overall, pharmacotherapy was fairly well implemented in HFrEF patients, although somewhat worse inp
Connolly SB, Kotseva K, Jennings C, et al., 2017, Outcomes of an integrated community-based nurse-led cardiovascular disease prevention programme, HEART, Vol: 103, Pages: 840-847, ISSN: 1355-6037
Wood DA, Arena R, Sagner M, et al., 2016, Welcome to Progress in Preventive Medicine from the editorial board., Progress in Preventive Medicine, Vol: 1, Pages: 1-2
van Halewijn G, Deckers J, Tay HY, et al., 2016, Lessons from contemporary trials of cardiovascular prevention and rehabilitation: A systematic review and meta-analysis, International Journal of Cardiology, Vol: 232, Pages: 294-303, ISSN: 0167-5273
Background:Meta-analyses of cardiac rehabilitation trials up to 2010 showed a significant reduction in all-cause mortality but many of these trials were conducted before the modern management of acute coronary syndromes.Methods:We undertook a meta-analysis of contemporary randomised controlled trials published in the period 2010 to 2015, including patients with other forms of atherosclerotic cardiovascular disease, to investigate the impact of cardiovascular prevention and rehabilitation on hard outcomes including survival.Results:18 trials randomising 7691 patients to cardiovascular prevention and rehabilitation or usual care were selected. All-cause mortality was not reduced (RR 1.00, 95% CI 0.88 to 1.14), but cardiovascular mortality was by 58% (95% CI 0.21, 0.88). Myocardial infarction was also reduced by 30% (95% CI 0.54, 0.91) and cerebrovascular events by 60% (95% CI 0.22, 0.74). Comprehensive programmes managing six or more risk factors reduced all-cause mortality in a subgroup analysis (RR 0.63, 95% CI 0.43, 0.93) but those managing less did not. In the three programmes that prescribed and monitored cardioprotective medications for blood pressure and lipids all-cause mortality was also reduced (RR 0.35, 95% CI 0.18, 0.70).Conclusions:Comprehensive prevention and rehabilitation programmes managing six or more risk factors, and those prescribing and monitoring medications within programmes to lower blood pressure and lipids, continue to reduce all-cause mortality. In addition, these comprehensive programmes not only reduced cardiovascular mortality and myocardial infarction but also, for the first time, cerebrovascular events, and all these outcomes across a broader spectrum of patients with atherosclerotic disease.
Gyberg V, De Bacquer D, Kotseva K, et al., 2016, Time-saving screening for diabetes in patients with coronary artery disease: a report from EUROASPIRE IV, BMJ Open, Vol: 6, ISSN: 2044-6055
Background WHO advocates 2-hour oral glucose tolerance test (OGTT) for detecting diabetes mellitus (DM). OGTT is the most sensitive method to detect DM in patients with coronary artery disease (CAD). Considered time consuming, the use of OGTT is unsatisfactory. A 1-hour plasma glucose (1hPG) test has not been evaluated as an alternative in patients with CAD.Objectives To create an algorithm based on glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 1hPG limiting the need of a 2-hour plasma glucose (2hPG) in patients with CAD.Methods 951 patients with CAD without DM underwent OGTT. A 2hPG≥11.1 mmol/L was the reference for undiagnosed DM. The yield of HbA1c, FPG and 1hPG was compared with that of 2hPG.Results Mean FPG was 6.2±0.9 mmol/L, and mean HbA1c 5.8±0.4%. Based on 2hPG≥11.1 mmol/L 122 patients (13%) had DM. There was no value for the combination of HbA1c and FPG to rule out or in DM (HbA1c≥6.5%; FPG≥7.0 mmol/L). In receiver operating characteristic analysis a 1hPG≥12 mmol/L balanced sensitivity and specificity for detecting DM (both=82%; positive and negative predictive values 40% and 97%). A combination of FPG<6.5 mmol/L and 1hPG<11 mmol/L excluded 99% of DM. A combination of FPG>8.0 mmol/L and 1hPG>15 mmol/L identified 100% of patients with DM.Conclusions Based on its satisfactory accuracy to detect DM an algorithm is proposed for screening for DM in patients with CAD decreasing the need for a 2-hour OGTT by 71%.
Wood DA, 2016, Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions, European Journal of Preventive Cardiology, ISSN: 2047-4873
Wood DA, 2016, Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey, European Journal of Preventive Cardiology, ISSN: 2047-4873
Piot P, Aerts A, Wood DA, et al., 2016, Innovating healthcare delivery to address noncommunicable diseases in low-income settings: the example of hypertension, Future Cardiology, Vol: 12, Pages: 401-403, ISSN: 1479-6678
Hypertension is a global health issue causing almost 10 million deaths annually, with adisproportionate number occurring in low- and middle-income countries. The condition canbe managed effectively, but there is a need for innovation in healthcare delivery to alleviateits burden. This paper presents a number of innovative delivery models from a numberof different countries, including Kenya, Ghana, Barbados and India. These models werepresented at the London Dialogue event, which was cohosted by the Novartis Foundationand the London School of Hygiene & Tropical Medicine Centre for Global NoncommunicableDiseases on 1 December 2015. It is argued that these models are applicable not only tohypertension, but provide valuable lessons to address other noncommunicable diseases.
Huffman MD, Perel P, Beller GA, et al., 2015, World Heart Federation Emerging Leaders Program An Innovative Capacity Building Program to Facilitate the 25 x 25 Goal, GLOBAL HEART, Vol: 10, Pages: 229-233, ISSN: 2211-8160
Gyberg V, De Bacquer D, De Backer G, et al., 2015, 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, Cardiovascular Diabetology, Vol: 14, ISSN: 1475-2840
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
Wood DA, Van de Werf F, 2014, The CardioScape Project, EUROPEAN HEART JOURNAL, Vol: 35, Pages: 2932-2933, ISSN: 0195-668X
Jennings C, Kotseva K, De Bacquer D, et al., 2014, Effectiveness of a preventive cardiology programme for high CVD risk persistent smokers: the EUROACTION PLUS varenicline trial, EUROPEAN HEART JOURNAL, Vol: 35, Pages: 1411-1420, ISSN: 0195-668X
Jennings CS, Kotseva K, De Bacquer D, et al., 2014, Principal results of the EUROASPIRE IV survey of CVD prevention and diabetes. Lifestyle, risk factor and therapeutic management in coronary patients from 24 European regions, Publisher: SAGE PUBLICATIONS LTD, Pages: S5-S5, ISSN: 1474-5151
Reiner Z, De Bacquer D, Kotseva K, et al., 2013, Treatment potential for dyslipidaemia management in patients with coronary heart disease across Europe: Findings from the EUROASPIRE III survey, ATHEROSCLEROSIS, Vol: 231, Pages: 300-307, ISSN: 0021-9150
Jones J, Barr S, Jennings C, et al., 2013, Training opportunities in preventive cardiology: MSc, Diploma and Certificate in Preventive Cardiology, British Journal of Cardiology, Vol: 20, ISSN: 0969-6113
Jenni S, Tillin T, Thomas L, et al., 2013, Marked reductions in hepatic fat after a cardiovascular prevention programme persist after one year despite weight regain, 49th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S322-S322, ISSN: 0012-186X
Ferrieres J, Amber V, Crisan O, et al., 2013, Total Lipid Management and Cardiovascular Disease in the Dyslipidemia International Study, CARDIOLOGY, Vol: 125, Pages: 154-163, ISSN: 0008-6312
Kwok S, Canoy D, Soran H, et al., 2012, Body fat distribution in relation to smoking and exogenous hormones in British women, CLINICAL ENDOCRINOLOGY, Vol: 77, Pages: 828-833, ISSN: 0300-0664
De Smedt D, Kotseva K, De Bacquer D, et al., 2012, Cost-effectiveness of optimizing prevention in patients with coronary heart disease: the EUROASPIRE III health economics project, EUROPEAN HEART JOURNAL, Vol: 33, Pages: 2865-U37, ISSN: 0195-668X
Thygesen K, Alpert JS, Jaffe AS, et al., 2012, Third Universal Definition of Myocardial Infarction, CIRCULATION, Vol: 126, Pages: 2020-+, ISSN: 0009-7322
Mistry H, Morris S, Dyer M, et al., 2012, Cost-effectiveness of a European preventive cardiology programme in primary care: a Markov modelling approach, BMJ Open, Vol: 2, ISSN: 2044-6055
Objective To investigate the longer-term cost-effectiveness of a nurse-coordinated preventive cardiology programme for primary prevention of cardiovascular disease (CVD) compared to routine practice from a health service perspective.Design A matched, paired cluster-randomised controlled trial.Setting Six pairs of general practices in six countries.Participants 1019 patients were randomised to the EUROACTION intervention programme and 1005 patients to usual care (UC) and who completed the 1-year follow-up.Outcome measures Evidence on health outcomes and costs was based on patient-level data from the study, which had a 1-year follow-up period. Future risk of CVD events was modelled, using published risk models based on patient characteristics. An individual-level Markov model for each patient was used to extrapolate beyond the end of the trial, which was populated with data from published sources. We used an 11-year time horizon and investigated the impact on the cost-effectiveness of varying the duration of the effect of the intervention beyond the end of the trial. Results are expressed as incremental cost per quality-adjusted life-year gained.Results Unadjusted results found the intervention to be more costly and also more effective than UC. However, after adjusting for differences in age, gender, country and baseline risk factors, the intervention was dominated by UC, but this analysis was not able to take into account the lifestyle changes in terms of diet and physical activity.Conclusions Although the EUROACTION study achieved healthier lifestyle changes and improvements in management of blood pressure and lipids for patients at high risk of CVD, compared to UC, it was not possible to show, using available risk equations which do not incorporate diet and physical activity, that the intervention reduced longer-term cardiovascular risk cost-effectively. Whether or not an intervention such as that offered by EUROACTION is cost-effective requires a longer-term trial
Thygesen K, Alpert JS, Jaffe AS, et al., 2012, Third universal definition of myocardial infarction, EUROPEAN HEART JOURNAL, Vol: 33, Pages: 2551-2567, ISSN: 0195-668X
Connolly SB, Kotseva K, Clements SJ, et al., 2012, MyAction Westminster: an innovative community-based vascular prevention service that improves blood pressure control and reduces overall cardiovascular risk, JOURNAL OF HUMAN HYPERTENSION, Vol: 26, Pages: 623-623, ISSN: 0950-9240
Ceponiene I, Kotseva K, Wood D, 2012, Educational status and cardiovascular risk factor profile of coronary patients in Europe: results of EUROASPIRE III survey, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 951-951, ISSN: 0195-668X
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