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Prediction of recurrent event in patients with coronary heart disease : the EUROASPIRE Risk Model : results from a prospective study in 27 countries in the WHO European region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC)

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Abstract
Aims Most patients with established atherosclerotic cardiovascular disease (CVD) are at very high risk for developing recurrent events. Since this risk varies a lot between patients there is a need to identify those in whom an even more intensive secondary prevention strategy should be envisaged. Using data from the EUROASPIRE IV and V cohorts of coronary heart disease (CHD) patients from 27 European countries, we aimed at developing and internally and externally validating a risk model predicting recurrent CVD events in patients aged < 75 years. Methods and results Prospective data were available for 12 484 patients after a median follow-up time of 1.7 years. The primary endpoint, a composite of fatal CVD or new hospitalizations for non-fatal myocardial infarction (MI), stroke, heart failure, coronary artery bypass graft, or percutaneous coronary intervention (PCI), occurred in 1424 patients. The model was developed based on data from 8000 randomly selected patients in whom the association between potential risk factors and the incidence of the primary endpoint was investigated. This model was then validated in the remaining 4484 patients. The final multivariate model revealed a higher risk for the primary endpoint with increasing age, a previous hospitalization for stroke, heart failure or PCI, a previous diagnosis of peripheral artery disease, self-reported diabetes and its glycaemic control, higher non-high-density lipoprotein cholesterol, reduced renal function, symptoms of depression and anxiety and living in a higher risk country. The model demonstrated excellent internal validity and proved very adequate in the validation cohort. Regarding external validity, the model demonstrated good discriminative ability in 20 148 MI patients participating in the SWEDEHEART register. Finally, we developed a risk calculator to estimate risks at 1 and 2 years for patients with stable CHD. Conclusion In patients with CHD, fatal and non-fatal rates of recurrent CVD events are high. However, there are still opportunities to optimize their management in order to prevent further disease or death. The EUROASPIRE Risk Calculator may be of help to reach this goal.
Keywords
Epidemiology, Cardiology and Cardiovascular Medicine, Coronary heart disease, Risk, Patient management, Recurrent events, DENSITY-LIPOPROTEIN CHOLESTEROL, DEPRESSION, MANAGEMENT, ASSOCIATION, CHALLENGE, PROGNOSIS, ANXIETY, COHORT

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MLA
De Bacquer, Dirk, et al. “Prediction of Recurrent Event in Patients with Coronary Heart Disease : The EUROASPIRE Risk Model : Results from a Prospective Study in 27 Countries in the WHO European Region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC).” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, vol. 29, no. 2, 2022, pp. 328–39, doi:10.1093/eurjpc/zwaa128.
APA
De Bacquer, D., Ueda, P., Reiner, Ž., De Sutter, J., De Smedt, D., Lovic, D., … for the EUROASPIRE IV and V National Coordinators, [missing]. (2022). Prediction of recurrent event in patients with coronary heart disease : the EUROASPIRE Risk Model : results from a prospective study in 27 countries in the WHO European region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC). EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 29(2), 328–339. https://doi.org/10.1093/eurjpc/zwaa128
Chicago author-date
De Bacquer, Dirk, Peter Ueda, Željko Reiner, Johan De Sutter, Delphine De Smedt, Dragan Lovic, Nina Gotcheva, et al. 2022. “Prediction of Recurrent Event in Patients with Coronary Heart Disease : The EUROASPIRE Risk Model : Results from a Prospective Study in 27 Countries in the WHO European Region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC).” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 29 (2): 328–39. https://doi.org/10.1093/eurjpc/zwaa128.
Chicago author-date (all authors)
De Bacquer, Dirk, Peter Ueda, Željko Reiner, Johan De Sutter, Delphine De Smedt, Dragan Lovic, Nina Gotcheva, Zlatko Fras, Nana Pogosova, Erkin Mirrakhimov, Seppo Lehto, Tomas Jernberg, Kornelia Kotseva, Lars Rydén, David Wood, Guy De Backer, and [missing] for the EUROASPIRE IV and V National Coordinators. 2022. “Prediction of Recurrent Event in Patients with Coronary Heart Disease : The EUROASPIRE Risk Model : Results from a Prospective Study in 27 Countries in the WHO European Region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC).” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY 29 (2): 328–339. doi:10.1093/eurjpc/zwaa128.
Vancouver
1.
De Bacquer D, Ueda P, Reiner Ž, De Sutter J, De Smedt D, Lovic D, et al. Prediction of recurrent event in patients with coronary heart disease : the EUROASPIRE Risk Model : results from a prospective study in 27 countries in the WHO European region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC). EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. 2022;29(2):328–39.
IEEE
[1]
D. De Bacquer et al., “Prediction of recurrent event in patients with coronary heart disease : the EUROASPIRE Risk Model : results from a prospective study in 27 countries in the WHO European region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC),” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, vol. 29, no. 2, pp. 328–339, 2022.
@article{8696870,
  abstract     = {{Aims Most patients with established atherosclerotic cardiovascular disease (CVD) are at very high risk for developing recurrent events. Since this risk varies a lot between patients there is a need to identify those in whom an even more intensive secondary prevention strategy should be envisaged. Using data from the EUROASPIRE IV and V cohorts of coronary heart disease (CHD) patients from 27 European countries, we aimed at developing and internally and externally validating a risk model predicting recurrent CVD events in patients aged < 75 years. Methods and results Prospective data were available for 12 484 patients after a median follow-up time of 1.7 years. The primary endpoint, a composite of fatal CVD or new hospitalizations for non-fatal myocardial infarction (MI), stroke, heart failure, coronary artery bypass graft, or percutaneous coronary intervention (PCI), occurred in 1424 patients. The model was developed based on data from 8000 randomly selected patients in whom the association between potential risk factors and the incidence of the primary endpoint was investigated. This model was then validated in the remaining 4484 patients. The final multivariate model revealed a higher risk for the primary endpoint with increasing age, a previous hospitalization for stroke, heart failure or PCI, a previous diagnosis of peripheral artery disease, self-reported diabetes and its glycaemic control, higher non-high-density lipoprotein cholesterol, reduced renal function, symptoms of depression and anxiety and living in a higher risk country. The model demonstrated excellent internal validity and proved very adequate in the validation cohort. Regarding external validity, the model demonstrated good discriminative ability in 20 148 MI patients participating in the SWEDEHEART register. Finally, we developed a risk calculator to estimate risks at 1 and 2 years for patients with stable CHD. Conclusion In patients with CHD, fatal and non-fatal rates of recurrent CVD events are high. However, there are still opportunities to optimize their management in order to prevent further disease or death. The EUROASPIRE Risk Calculator may be of help to reach this goal.}},
  author       = {{De Bacquer, Dirk and Ueda, Peter and Reiner, Željko and De Sutter, Johan and De Smedt, Delphine and Lovic, Dragan and Gotcheva, Nina and Fras, Zlatko and Pogosova, Nana and Mirrakhimov, Erkin and Lehto, Seppo and Jernberg, Tomas and Kotseva, Kornelia and Rydén, Lars and Wood, David and De Backer, Guy and for the EUROASPIRE IV and V National Coordinators, [missing]}},
  issn         = {{2047-4873}},
  journal      = {{EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY}},
  keywords     = {{Epidemiology,Cardiology and Cardiovascular Medicine,Coronary heart disease,Risk,Patient management,Recurrent events,DENSITY-LIPOPROTEIN CHOLESTEROL,DEPRESSION,MANAGEMENT,ASSOCIATION,CHALLENGE,PROGNOSIS,ANXIETY,COHORT}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{328--339}},
  title        = {{Prediction of recurrent event in patients with coronary heart disease : the EUROASPIRE Risk Model : results from a prospective study in 27 countries in the WHO European region-The EURObservational Research Programme (EORP) of the European Society of Cardiology (ESC)}},
  url          = {{http://doi.org/10.1093/eurjpc/zwaa128}},
  volume       = {{29}},
  year         = {{2022}},
}

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