Cardiovascular outcome in patients with high risk cardiovascular events in Nakornping Hospital

Cardiovascular Outcomes in atherosclerotic disease group

Authors

  • Siriwattana K Department of Internal Medicine, Nakornping Hospital, Chiang Mai, Thailand
  • Siriaree K Department of Internal Medicine, Nakornping Hospital, Chiang Mai, Thailand
  • Hinmali K Nursing Department, Nakornping Hospital, Chiang Mai, Thailand

Keywords:

composite cardiovascular outcome, patients with high risk cardiovascular events

Abstract

Objectives  Patients with atherosclerosis are at different levels of elevated risk of ischemic events depending on the specific manifestation of the disease and may have varying degrees of future risk for ischemic events. This study evaluated the incidence of composite cardiovascular outcomes of patients with high risk cardiovascular events in Nakornping Hospital.

Methods This prospective observational non-interventional cohort study enrolled patients age 45 years or more who met the inclusion criteria of the Outpatient Department of Medicine, Nakornping Hospital, between January 2008 and December 2009. The follow-up period for each patient was 60 months. The composite cardiovascular outcome of cardiovascular deaths, non-fatal myocardial infarctions, non-fatal strokes and hospitalizations for heart failure was determined.

Results  Of the 387 patients in the Outpatient Department of Medicine of Nakornping Hospital, 103 were in the established atherosclerotic disease group and 284 were in the multiple risk factors group. The rate of overall composite cardiovascular events (cardiovascular death, non-fatal MI, non-fatal stroke, and hospitalization for heart failure) was 3.83%.  The rate was higher in the established atherosclerotic disease group than in the multiple risk factors group 6.79% vs. 1.41% (HR = 14.28; 95% CI, 2.26-90.02, p = 0.005) which was driven by hospitalization for heart failure, but the established atherosclerotic disease group had a lower rate of medical treatment for diabetes than the multiple risk factors group. The rate of receipt of anti-diabetic drugs was statistically significantly lower in the established atherosclerotic disease group than in the multiple risk factors group.

Conclusions Patients with established atherosclerotic disease have a higher rate of composite cardiovascular outcomes than patients with multiple risk factors, but they have a lower rate of medical treatment for diabetes. 

References

Lloyd JD, Adams R, Carnethon M, Mercedes C, Gio-vanni DS, Bruce F, Ketherrine F, et al. Heart disease and stroke statistics-2009 update: a report from the Ameri-can Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21-181.

Rodgers A, Ezzati M, Vander HS, Lopez AD, Lin RB, Murphy CJ, et al. Distribution of major health risks: findings from the Global Burden of Disease study. PloS Med. 2004;1:e27.

Fieck F. Cardiovascular disease- a global health time bomb. Bull World Health Organ. 2004;82:470-1.

Levenson JW, Skerrett PJ, Gazziano JM. Reducing the global burden of cardiovascular disease: the role of risk factors. Prev Cardiol. 2002;5:188-99.

Yusuf F, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general consideration, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746-53

Ian G, Dan A, Knut BJ, Gudrun B, Gunilla B, Rente C, et al. European guidelines on. cardiovascular disease pre-vention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Diseases Pre-vention in Clinical Practice. Eur Heart J. 2007;28:2375-414. 7. Dirks JH, Robinson SW, Alderman M, Couser WG, Grudz SM, Smith SC, et al. Meeting report on the Bel-lagio Conference prevention of vascular diseases in the emerging world: an approach to global health equity. Kidney Int. 2006;70:1397-402.

Clement DL, Belch JJ. Vascular disease public educa-tion the mandate is national. IntAngiol. 2004;23:1-4.

Yusuf F, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part II: variation in cardiovas-cular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001; 104:2855-64

The interASIA Collaborative Group. Cardiovascular risk factor levels in urban and rural Thailand- The In-ternational Collaborative Study of Cardiovascular Dis-ease in Asia (InterASIA). Eur J Cardiovasc Prevention Rehab. 2003;10:249-57.

Bhatt DL, Kim AE, Ohmann EM, Alan TH, Shinya G, Elizabeth MM, et al. Comparative determinants of 4-year cardiovascular events rates in stable outpa-tients at risk of or with atherothrombosis. JAMA. 2010; 304:1350-57.

Tocharoenvanich P, Yipintsoi T, Choomalee K, Boon-wanno P, Rodklaib. Risk Factors A Five-Year Death in The InterASIA-South Cohort. J Med Assoc Thai. 2008; 91:471-78.

Sritara P, Cheepudomwit S, Chapman N, Woodward M, Kositchaiwat C, Tunlayadechanont S, et al. Twelve-year changed in vascular risk factors and their associations with mortality in a cohort of 3499 Thais: the Electricity Generating Authortity of Thailand study. Int J Epide-miol. 2003;32:461-68.

Phrommintikul A, Krittayaphong R, Wongcharoen W, Yamwong S, Boonyaratavej S, Kunjara-Na-Ayudhya R, et al. Management of atherosclerotic risk factors for pa-tients at high cardiovascular risk in real-world practice: a multicenter study. Singapore Med J. 2017;58:535-42.

Massimo FP, Arno WH, Stafan A, Christain A, Carlos B, Alberto LC, et al. 2016 European guidelines on car-diovascular disease prevention in clinical practice: The sixth joint task force of the european society of cardio-logy and other society on cardiovascular disease preven-tion in clinical practice. Eur Heart J. 2016;37:2315-81.

Donna KA, Roger S, Michelle AA, Andrew BB, Zadary DG, Ellen JH, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Execu-tive Summary. Circualtion. 2019;140: e563-95.

The Royal College of the Physician of Thailand. 2016 RCPT Clinical Practice Guideline on Pharmacologic Therapy of Dyslipidemia for Atherosclerotic Cardio-vascular Disease Prevention. The Royal College of the Physician of Thailand; 2016.

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Published

2021-01-01

How to Cite

1.
K S, K S, K H. Cardiovascular outcome in patients with high risk cardiovascular events in Nakornping Hospital : Cardiovascular Outcomes in atherosclerotic disease group. BSCM [Internet]. 2021 Jan. 1 [cited 2024 May 5];60(1):17-26. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/242169

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Original Article