Pichlhöfer Otto, Maier Manfred, Badr-Eslam Roza, Ristl Robin, Zebrowska Magdalena, Lang Irene M
Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine II, Division of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
PLoS One. 2017 Apr 27;12(4):e0176257. doi: 10.1371/journal.pone.0176257. eCollection 2017.
Cardiovascular disease is the main cause of death in Austria. However, no systematic information exists regarding characteristics and treatments of contemporary patients with stable coronary artery disease (CAD) in Austria. We assembled two retrospective physicians' databases to describe demographics, clinical profiles, and therapeutic strategies in patients with stable CAD. In addition, we compared patient profiles of secondary care internists and hospital-based cardiologists with those of general practitioners in a primary care setting outside of hospital.
The study population was identified from retrospective chart review of 1020 patients from 106 primary care physicians in Austria (ProCor II registry), and was merged with a previous similar database of 1280 patients under secondary care (ProCor I registry) to yield a total patient number of 2300.
Female patients with stable CAD were older, had more angina and/or heart failure symptoms, and more depression than males. Female gender, type 2 diabetes mellitus, higher CCS class and asthma/COPD were predictors of elevated heart rate, while previous coronary events/revascularization predicted a lower heart rate in multivariate analysis. There were no significant differences with regard to characteristics and management of patients of general practitioners in the primary care setting versus internists in secondary care.
Characteristics and treatments of unselected patients with stable ischemic heart disease in Austria resemble the pattern of large international registries of stable ischemic heart disease, with the exception that diabetes and systemic hypertension were more prevalent.
心血管疾病是奥地利的主要死因。然而,目前尚无关于奥地利当代稳定型冠状动脉疾病(CAD)患者特征及治疗情况的系统信息。我们收集了两个回顾性医生数据库,以描述稳定型CAD患者的人口统计学特征、临床概况和治疗策略。此外,我们还将二级医疗内科医生和医院心内科医生管理的患者资料与医院外基层医疗环境中全科医生管理的患者资料进行了比较。
通过对奥地利106名基层医疗医生的1020例患者进行回顾性病历审查确定研究人群,并将其与之前一个包含1280例二级医疗患者的类似数据库(ProCor I注册库)合并,最终患者总数达2300例。
稳定型CAD女性患者比男性患者年龄更大,心绞痛和/或心力衰竭症状更多,抑郁情况也更多。在多变量分析中,女性、2型糖尿病、较高的加拿大心血管学会(CCS)分级以及哮喘/慢性阻塞性肺疾病(COPD)是心率升高的预测因素,而既往冠状动脉事件/血运重建则预测心率较低。在基层医疗环境中,全科医生管理的患者与二级医疗内科医生管理的患者在特征和管理方面无显著差异。
奥地利未经选择的稳定型缺血性心脏病患者的特征和治疗情况与大型国际稳定型缺血性心脏病注册研究的模式相似,不同之处在于糖尿病和系统性高血压更为普遍。