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慢性冠状动脉综合征对心血管住院和死亡率的影响:ESC-EORP CICD-LT 注册研究。

Impact of chronic coronary syndromes on cardiovascular hospitalization and mortality: the ESC-EORP CICD-LT registry.

机构信息

Sorbonne University, ACTION Study Group, INSERM UMRS1166, ICAN-Institute of Cardio Metabolism and Nutrition Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France.

Unit of Cardiology, Karolinska Institute and Karolinska University Hospital Solna, Stockholm, Sweden.

出版信息

Eur J Prev Cardiol. 2022 Nov 8;29(15):1945-1954. doi: 10.1093/eurjpc/zwac089.

Abstract

AIMS

In Europe, global data on guideline adherence, geographic variations, and determinants of clinical events in patients with chronic coronary syndrome (CCS) remain suboptimal. The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischemic Cardiovascular Disease Long-Term (CICD-LT) registry is a prospective European registry, and was designed to describe the profile, management, and outcomes of patients with CCS across the ESC countries.

METHODS AND RESULTS

We aimed to investigate clinical events at 1-year follow-up from the ESC EORP CICD-LT registry.One-year outcomes of 6655 patients from the 9174 recruited in this European registry were analysed. Overall, 168 patients (2.5%) died, mostly from cardiovascular (CV) causes (n = 97, 1.5%). Northern Europe had the lowest CV mortality rate, while southern Europe had the highest (0.5 vs. 2.0%, P = 0.04). Women had a higher rate of CV mortality compared with men (2.0 vs. 1.3%, P = 0.02). During follow-up, 1606 patients (27.1%) were hospitalized at least once, predominantly for CV indications (n = 1220, 20.6%). Among the population with measured low-density lipoprotein-cholesterol level at 1 year, 1434 patients (66.5%) were above the recommended target. Age, history of atrial fibrillation, previous stroke, liver disease, chronic obstructive pulmonary disease or asthma, increased serum creatinine, and impaired left ventricular function were associated with an increased risk of CV death or hospitalization.

CONCLUSION

In the CICD registry, the majority of patients with CCS have uncontrolled CV-risk factors. The 1-year mortality rate is low, but these patients are frequently hospitalized for CV causes. Early identification of comorbidities may represent an opportunity for enhanced care and better outcomes.

摘要

目的

在欧洲,关于慢性冠状动脉综合征(CCS)患者遵循指南的情况、地域差异以及临床事件决定因素的全球数据仍不理想。欧洲心脏病学会(ESC)欧洲观察性研究计划(EORP)慢性缺血性心血管疾病长期(CICD-LT)登记处是一个前瞻性的欧洲登记处,旨在描述 ESC 国家 CCS 患者的特征、管理和结局。

方法和结果

我们旨在研究 ESC EORP CICD-LT 登记处的 1 年随访期间的临床事件。对该欧洲登记处招募的 9174 例患者中的 6655 例患者的 1 年结局进行了分析。总体而言,168 例患者(2.5%)死亡,主要死于心血管(CV)原因(n = 97,1.5%)。北欧的 CV 死亡率最低,而南欧最高(0.5%比 2.0%,P = 0.04)。女性的 CV 死亡率高于男性(2.0%比 1.3%,P = 0.02)。随访期间,1606 例患者(27.1%)至少住院一次,主要是由于 CV 原因(n = 1220,20.6%)。在 1 年时测量低密度脂蛋白胆固醇水平的人群中,1434 例患者(66.5%)高于推荐目标。年龄、心房颤动史、既往卒中、肝病、慢性阻塞性肺疾病或哮喘、血清肌酐升高和左心室功能障碍与 CV 死亡或住院的风险增加相关。

结论

在 CICD 登记处,大多数 CCS 患者存在未得到控制的 CV 危险因素。1 年死亡率较低,但这些患者经常因 CV 原因住院。早期识别合并症可能为加强护理和改善结局提供机会。

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