Incidence of cardiovascular events in patients with stabilized coronary heart disease: the EUROASPIRE IV follow-up study

AbstractThe EUROASPIRE surveys (EUROpean Action on Secondary Prevention through Intervention to Reduce Events) demonstrated that most European coronary patients fail to achieve lifestyle, risk factor and therapeutic targets. Here we report on the 2-year incidence of hard cardiovascular (CV) endpoints in the EUROASPIRE IV cohort. EUROASPIRE IV (2012 –2013) was a large cross-sectional study undertaken at 78 centres from selected geographical areas in 24 European countries. Patients were interviewed and examined at least 6 months following hospitalization for a coronary event or procedure. Fatal and non-fatal CV events occurring at least 1 ye ar after this baseline screening were registered. The primary outcome in our analyses was the incidence of CV death or non-fatal myocardial infarction, stroke or heart failure. Cox regression models, stratified for country, were fitted to relate baseline characteristics to outcome. Our analyses incl uded 7471 predominantly male patients. Overall, 222 deaths were registered of whom 58% were cardiovascular. The incidence of the primary outcome was 42 per 1000 person-years. Comorbidities were strongly and significantly associated with the primary outcome (multivariately adjusted hazard ratio HR, 9 5% confidence interval): severe chronic kidney disease (HR 2.36, 1.44–3.85), uncontrolled diabetes (HR 1.89, 1.50–2.38), resting heart rate ≥ 75 bpm (HR 1.74, 1.30–2.32), history of stroke (HR 1.70, 1....
Source: European Journal of Epidemiology - Category: Epidemiology Source Type: research

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CONCLUSIONS: In patients with T2DM and CKD, SGLT2 inhibitors have a decreased glucose-lowering effect compared to patients without CKD. Renal benefits among patients with CKD are similar to those without CKD and include a significant reduction in albuminuria and reduced incidence of worsening albuminuria. Given that CKD and T2DM are both associated with increased cardiovascular risk, we believe these agents should considered as preferred add-on agents in most patients with uncontrolled T2DM and eGFR>30 ml/min/1.73m2. Ongoing studies will provide additional information as to whether these agents should be added to the cu...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
The β-blocker uptitration in elderly with heart failure regarding biomarker levels: CIBIS-ELD substudy. Biomark Med. 2018 Nov 19;: Authors: Cvetinovic N, Sekularac N, Haehling SV, Tahirovic E, Inkrot S, Lainscak M, Apostolovic S, Putnikovic B, Waagstein F, Gelbrich G, Aleksic A, Loncar G, Düngen HD Abstract AIM: We investigated if the baseline value of mid-regional pro-atrial natriuretic peptide (NP), N-terminal pro-B-type NP and copeptin may be helpful in optimizing β-blocker uptitration in elderly patients with heart failure. PATIENTS &METHODS: According to the biomarkers'...
Source: Future Medicine: Biomarkers in Medicine - Category: Internal Medicine Tags: Biomark Med Source Type: research
CONCLUSIONS: Only women showed an income-based gradient in diabetes. Monitoring income gradient in diabetes is important in public health actions, even in older populations. Future longitudinal and intervention studies should evaluate the causal link of income to diabetes onset, determine the mechanisms of the potential sex differences in the income/diabetes association, and identify ways to mitigate the income-based inequality. PMID: 30449769 [PubMed - as supplied by publisher]
Source: Journal of Epidemiology - Category: Epidemiology Tags: J Epidemiol Source Type: research
This study tested the integrated model of suicide help-seeking to examine help-seeking behavior as a continuous decision-making process. Data were drawn from the 2011 and 2012 National Survey on Drug Use and Health (N = 1,414). Results from structural equational modeling analyses demonstrated that the integrated model fit reasonably well among the sample. Suicide help-seeking behavior is characterized by an inequitable access, where enabling factors affect throughout the help-seeking pathway. The results provide a foundation for future help-seeking interventions. PMID: 30451101 [PubMed - as supplied by publisher]
Source: Social Work in Public Health - Category: International Medicine & Public Health Tags: Soc Work Public Health Source Type: research
The Bottom Line: Some Texas physicians are trying to help prevent suicides with mental health screening and identifying patients ’ suicidal thoughts during a routine examination. Data shows most victims visit a doctor shortly before taking his or her life.
Source: TMA News Room - Category: Consumer Health News Source Type: news
High-deductible insurance plans delay the time patients take to seek healthcare services, potentially compromising health outcomes for those with diabetes, but the differences were modest.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Diabetes & Endocrinology News Source Type: news
Conclusion: The results of the study are significant as they clearly demonstrate a weak negative relationship between clothing preferences/affiliations and eating disorders.
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
After a shooting at Mercy Hospital in Chicago killed three people, including two hospital workers, doctors across the country are continuing to speak out against gun violence — and they’re pushing back on the National Rifle Association’s (NRA) admonition that they should “stay in their lane.” Earlier this month, the NRA responded to an Annals of Internal Medicine position paper on the urgency of reducing firearm fatalities with a tweet directing “self-important anti-gun doctors” to “stay in their lane.” The backlash from the medical community was swift and strong, with ...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthytime medicine onetime Source Type: news
Postural Instability (PI) is a major reason for fall in geriatric population as well as for people with diseases or disorders like Parkinson's, stroke etc. Conventional stability indicators like Berg Balance Scale (BBS) require clinical settings with skill...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
BACKGROUND: Complete abstinence from alcohol as well as smoking cessation have been shown to predict reductions in depressive symptoms over time. However, whether reducing alcohol use or smoking positively affect depressive symptoms has yet to be examined....
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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