The management of outpatients with stable coronary artery disease in clinical practice.

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Presentation transcript:

The management of outpatients with stable coronary artery disease in clinical practice

Need for contemporary data in stable CAD  Data from randomized clinical trials often have limited external validity (generalizability) highly selected patient populations highly selected patient populations often limited to specific geographic settings often limited to specific geographic settings often limited to pts with angina or with acute coronary syndrome often limited to pts with angina or with acute coronary syndrome most data pertain to hospitalized patients most data pertain to hospitalized patients many studies antedate the advent of modern prescriptions many studies antedate the advent of modern prescriptions  In addition, there is a lack data on heart rate actually achieved in practice and its relation to outcomes CAD: coronary artery disease

 An international, prospective, observational longitudinal registry in outpatients with stable CAD  The population of the CLARIFY will cover the entire spectrum of the outpatients with CAD  5 years follow-up Worldwide contemporary registry in outpatients with stable CAD CAD: coronary artery disease

Europe Americas Argentina Brazil Canada Mexico West Indies 39 countries 39 countries Asia China Korea Malaysia Singapore Thailand Middle East & Africa Gulf Countries Saudi Arabia South Africa Australia Slovakia Slovenia Ukraine Lithuania Spain UK Poland Portugal Romania Russia Austria Belgium/lLuxembourg Bulgaria Czech Republic Denmark Finland France Germany Greece Hungary Italy Ireland Latvia Lithuania Netherlands

 Characterize contemporary CAD patients (demographic characteristics, clinical profile) Objectives  Describe their management and outcomes over 5 years of follow-up  Identify gaps between treatment and evidence  Determine the long-term prognostic determinants in CAD, including resting heart rate, and develop a robust risk prediction model CAD: coronary artery disease

Stable coronary artery disease proven by history of at least one of the following: Inclusion criteria Chest pain with myocardial ischemia proven by stress ECG, stress echocardiography or myocardial imaging Chest pain with myocardial ischemia proven by stress ECG, stress echocardiography or myocardial imaging Coronary angiography showing at least one coronary stenosis of more than 50% Coronary angiography showing at least one coronary stenosis of more than 50% Documented myocardial infarction (more than 3 months ago) Documented myocardial infarction (more than 3 months ago) PCI or CABG (more than 3 months ago) PCI or CABG (more than 3 months ago)

Data to be collected(eCRF) Follow-up History and clinical examination; regular medications Clinical examination; regular medications; clinical outcomes * Every 6 months – phone call (health status, address) Data collection 60 months 48 months 36 months 24 months 12 months Baseline

Importance of CLARIFY Will provide data on HR and outcomes in “real world” contemporary outpatients with stable CAD; clinical and demographic aspects of the disease and treatment Will provide data on HR and outcomes in “real world” contemporary outpatients with stable CAD; clinical and demographic aspects of the disease and treatment Will provide dynamic estimation of the changing patterns of HR management, disease presentation, and therapy Will provide dynamic estimation of the changing patterns of HR management, disease presentation, and therapy Will help to develop a risk prediction tool based on HR Will help to develop a risk prediction tool based on HR Will give robust data for global and national publications, for scientific communications (congresses, abstracts), for health care administrators Will give robust data for global and national publications, for scientific communications (congresses, abstracts), for health care administrators Will provide data for educational programs Will provide data for educational programs HR: heart rate CAD: coronary artery disease