Purpose Methods Results Conclusions The aim was to determine the annual rate of cardiovascular events in an outpatient population with established cardiovascular.

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Presentation transcript:

Purpose Methods Results Conclusions The aim was to determine the annual rate of cardiovascular events in an outpatient population with established cardiovascular disease or multiple atherothrombotic risk factors and their relationship to the control of the cardiovascular risk factors, lifesyle and sociodemogrphic variables. The PREVENT-A is a prospective epidemiological study to determine the occurrence of cardiovascular events in 1032 patients with symptomatic cardiovascular disease (94,5%) or multiple risk factors (5,5%) in a region of southern Spain. The primary endpoint was the occurrence of cardiovascular death (CVD), nonfatal myocardial infarction (NFMI) or stroke and combined endpoint (MACE), one year follow-up. Since January 2008, results were obtained in 1032 patients (72.4% men) with a mean age of 67.2 years (SD: 9.4) years. The annual rate of CVD, NFMI and stroke was 1.7%, 31.6% and 30.7% respectively and 35% for combined endpoint (MACE). The events rates increased with the number of symptomatic arterial disease locations, ranking from 22,0% for patients with multiple risk factors to 32,3%, 32,9% an 43,8% for patients with 1, 2 and 3 o more symptomatic arterial disease location (p: 0,03). In general patients were adecuately treated with antihypertensive drugs (97%), antiplatelet agents (95%) and statins (88,9%). Hypertension, diabetes and hypercholesterolemia was controlled in 25,1%, 56,1% and 50,9%, respectively according to the current recomendation for secondary prevention. Statistically significant differences were observed in the control of diabetes and the presence of combined endpoint (47.9 vs 60.6%, P <0.05) but not in the control of blood pressure, dyslipidemia and abdominal obesity. (Figure 1) The MACE rate was significantly more frequent in smokers (36.5% vs 27.1%, p = 0.002). Moderate alcohol consumption and physical exercise regularly were significantly more frequent in patients without events (14.6% vs 8.8%, p = 0.008) and (51.0% vs 38.2%, p = ). There were no differences in educational attainment and field of residence between patients with and without events. In this study in southern Spain in most patients with atherosclerotic coronary disease, there was a high annual rate of ischemic events: these rates increase in close association with polyvascular disease, smoking and poorly controled diabetes and decrease with exercise and moderate alcohol drinking. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved. Thus, additional efforts to modify the habits of life in this population should be achieved. One-year cardiovascular ischemic event rates in high risk outpatients in southern Spain: The PREVENT-A registry E.Gonzalez Cocina 1, MA. Ulecia Martínez 2, J. Caballero Gueto 2, E. Otero Chulian 3, M. Lagares Carballo 3, M. De Mora Martín 4, A. Martínez Martínez 5, A. Lopez Granados 6, E. Vazquez De Castroviejo 7, A. Martín Santana 8. (1) Hospital Costa del Sol, Marbella-Málaga, Spain. (2) Hospital Clínico, Granada, Spain. (3) Puerta del Mar University Hospital, Cádiz, Spain. (4) Regional Uniersity Hospital Carlos Haya, Málaga, Spain (5) Hospital Virgen del Rocio, Sevilla, Spain. (6) University Hospital Reina Sofía, Córdoba, Spain. (7) Hospital de Jaen, Jaen, Spain. (8) Hospital General de Jerez, Jerez, Spain. VariablesN (%) Age67,2 ± 9,4 Gender (M)72,4 Smokers/ Ex-smokers191 (18,5) Moderate alcohol consume131 (12,7) Exercise364 (35,2) Hypertension1014 (98,3) Dyslipidemia1004 (97,3) Diabetes677 (65,6) Obesity398 (38,6) Abdominal obesity500 (48,4) Family history of cardiovascular disease 147 (14,2) Clinical caracteristics of patients. (Table 1) HypertensionDiabetesDyslipiedmia Abdominal obesity Controlled Not controlled Event (n=340) No event (n=683) 75,9 24,1 74,4 25,6 Event (n=140) No event (n=287) 52,1 47,9 39,4 60,6 Event (n=286) No event (n=639) 50,3 49,7 49,3 50,7 Event (n=245) No event (n=479) 66,1 33,9 60,5 39,5 Figure 1