1 Department of Cardiology, Hopital Saint Joseph, France.
2 GVM Care and Research, Maria Cecilia Hospital, Italy.
Eur J Prev Cardiol. 2018 Mar;25(4):377-387. doi: 10.1177/2047487317751955. Epub 2018 Jan 16.
Aim Chronic ischaemic cardiovascular disease (CICD) remains a leading cause of morbidity and mortality worldwide. The CICD Pilot Registry enrolled 2420 patients across 10 European Society of Cardiology countries prospectively to describe characteristics, management strategies and clinical outcomes in this setting. We report here the six-month outcomes. Methods and results From the overall population, 2203 patients were analysed at six months. Fifty-eight patients (2.6%) died after inclusion; 522 patients (23.7%) experienced all-cause hospitalisation or death. The rate of prescription of angiotensin-converting enzyme inhibitors, beta-blockers and aspirin was mildly decreased at six months (all P < 0.02). Patients who experienced all-cause hospitalisation or death were older, more often had a history of non-ST-segment elevation myocardial infarction, of chronic kidney disease, peripheral revascularisation and/or chronic obstructive pulmonary disease than those without events. Independent predictors of all-cause mortality/hospitalisation were age (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07-1.27) per 10 years, and a history of previous peripheral revascularisation (HR 1.45, 95% CI 1.03-2.03), chronic kidney disease (HR 1.31, 95% CI 1.0-1.68) or chronic obstructive pulmonary disease (HR 1.42, 95% CI 1.06-1.91, all P < 0.05). We observed a higher rate of events in eastern, western and northern countries compared to southern countries and in cohort 1. Conclusion In this contemporary European registry of CICD patients, the rate of severe clinical outcomes at six months was high and was influenced by age, heart rate and comorbidities. The medical management of this condition remains suboptimal, emphasising the need for larger registries with long-term follow-up. Ad-hoc programmes aimed at implementing guidelines adherence and follow-up procedures are necessary, in order to improve quality of care and patient outcomes.
慢性缺血性心血管疾病（CICD）仍然是全球发病率和死亡率的主要原因。CICD 试点注册中心在 10 个欧洲心脏病学会国家前瞻性地招募了 2420 名患者，以描述该环境下的特征、管理策略和临床结局。我们在此报告六个月的结果。
在总体人群中，2203 名患者在六个月时进行了分析。纳入后有 58 名患者（2.6%）死亡；522 名患者（23.7%）经历了全因住院或死亡。血管紧张素转换酶抑制剂、β受体阻滞剂和阿司匹林的处方率在六个月时略有下降（均 P<0.02）。经历全因住院或死亡的患者比无事件患者年龄更大，更常患有非 ST 段抬高型心肌梗死、慢性肾脏病、外周血管重建和/或慢性阻塞性肺疾病。全因死亡率/住院的独立预测因素是年龄（每增加 10 岁，风险比（HR）为 1.17，95%置信区间（CI）为 1.07-1.27），以及先前外周血管重建（HR 为 1.45，95%CI 为 1.03-2.03）、慢性肾脏病（HR 为 1.31，95%CI 为 1.0-1.68）或慢性阻塞性肺疾病（HR 为 1.42，95%CI 为 1.06-1.91，均 P<0.05）。与南部国家和队列 1 相比，我们观察到东部、西部和北部国家的事件发生率更高。
在这项当代欧洲 CICD 患者注册研究中，六个月时严重临床结局的发生率较高，且受年龄、心率和合并症的影响。该疾病的医疗管理仍不理想，强调需要进行长期随访的更大规模注册研究。需要制定专门的方案，以执行指南的遵守和随访程序，从而提高护理质量和患者结局。
