1. One-year cardiovascular ischemic event rates in high risk outpatients in southern Spain: The PREVENT-A registry
E.Gonzalez Cocina1 , MA. Ulecia Martínez2, J. Caballero Gueto2, E. Otero Chulian3, M. Lagares Carballo3, M. De Mora Martín4, A. Martínez Martínez5, A. Lopez Granados6, E. Vazquez De Castroviejo7, A. Martín Santana8.
(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.
Results
Purpose
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).
Of baseline variables analize, BMI and waist circumference were significantly higher in patients with MACE (29.8 vs.29.3; p = 0.04) and (105.4 vs 101.2; p = 0.02): Vascular interventions were more frequent among patients with MACE both at baseline and during follow-up (47.2% vs 36.0%; p= ). Statistically significant differences were observed in the control of diabetes and the presence of combined endpoint (55.9 vs. 66.7%; p<0.05) but not in the control of blood pressure, dyslipemia and abdominal obesity.
The MACE rate was significantly more frequent in smokers (36.5% vs. 27.1%, p=0.002) Moderate alcohol consumption and physical exercise regulary were significantly more frequent among patients without events (14.6% vs.8.8%, p= 0.008) and (51.0% vs 38.2%, p=0.0002). There were no differences in educational attainment and fiels of residence between patients with and without events.
The logistic regression analysis (Table 2) demonstrates that age (>68 years), being a smoker or former smoker and no alcohol consumption were independent predictors of cardiovascular death, NFMI and stroke.
The aim was to determine the anual rate of cardiovascular events in an outpatient population with established cardiovascular disease or multiple atherothrombotic risk factors and their relationship to sociodemographic and clinical variables.
Methods
The PREVENT-A is a prospective epidemiological study to determine the occurance 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.
Logistic regression analisis for prediction of cardiovascular events. (Table 2)
Variable
CVD
OR (95% IC) P value
NFMI
Stroke
MACE
Age>68 years
9,228 (2,110-40,355)
0,003
1,127 (1,057-1,203)
0,0003
Smokers/ex-smokers
1,80 (1,31-2,47)
0,001
1,88 (1,369-2,581)
0,0005
No alcohol consume
1,880 (1,190-2,996)
0,007
1,947 (1,220-3,106)
0,005
Clinical caracteristics of patients. (Table 1)
Variables
N (%)
Age
67,2 ± 9,4
Gender (M)
72,4
Smokers/ Ex-smokers
191 (18,5)
Moderate alcohol consume
131 (12,7)
Exercise
364 (35,2)
Hypertension
1014 (98,3)
Dyslipidemia
1004 (97,3)
Diabetes
677 (65,6)
Obesity
398 (38,6)
Abdominal obesity
500 (48,4)
Family history of cardiovascular disease
147 (14,2)
Conclusions
In this study in Southern Spain in most patients with atherosclerotic coronary disease, there was a high annual rate of ischemic events in relation to age, smoking, prior vascular interventions and inadequate control of diabetes. We observed a protective effect of moderate alcohol consumption.