Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology.
Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology.
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DOI：
10.1186/s12933-015-0296-y
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发表时间：
2015-10-01
影响因子：
9.3
通讯作者：
EUROASPIRE Investigators
中科院分区：
文献类型：
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作者：
Gyberg V;De Bacquer D;De Backer G;Jennings C;Kotseva K;Mellbin L;Schnell O;Tuomilehto J;Wood D;Rydén L;Amouyel P;Bruthans J;Conde AC;Cifkova R;Deckers JW;De Sutter J;Dilic M;Dolzhenko M;Erglis A;Fras Z;Gaita D;Gotcheva N;Goudevenos J;Heuschmann P;Laucevicius A;Lehto S;Lovic D;Miličić D;Moore D;Nicolaides E;Oganov R;Pająk A;Pogosova N;Reiner Z;Stagmo M;Störk S;Tokgözoğlu L;Vulic D;EUROASPIRE Investigators
为了影响每天的临床实践，专业组织发布管理指南。采用跨部门调查来评价这些准则的执行情况。本研究调查了冠状动脉疾病患者的血糖紊乱筛查，并将已知和新发现的2型糖尿病患者与非糖尿病患者的生活方式和药理学风险因素管理与当代欧洲指南进行了比较。EUROASPIRE IV研究了2012-2013年来自24个欧洲国家的共6187例患有冠状动脉疾病且基于自我报告的糖尿病史（既往已知糖尿病）或口服葡萄糖耐量试验结果和HbA 1c（无糖尿病或新诊断的糖尿病）已知贫血状态的患者（18-80岁）。对患者进行了访谈和调查，以便将其实际风险因素控制与当前欧洲管理指南中推荐的风险因素控制和先前进行的调查结果进行比较。共有2846例（46%）患者没有糖尿病，1158例（19%）新诊断的糖尿病和2183例（35%）先前已知的糖尿病。在这些组中，所有四种心脏保护药物的联合使用分别为53%、55%和60%。68%、61%和54%的患者实现了<140/90 mmHg的血压目标，16%、18%和28%的患者实现了<1.8 mmol/L的LDL-胆固醇目标。95例新诊断和既往已知糖尿病患者达到HbA 1c <7.0%（53 mmol/mol），53%和11%既往已知糖尿病患者HbA 1c> 9.0%（>75 mmol/mol）。在糖尿病患者中，69%的人报告身体活动量低。参加心脏康复计划的患者比例很低（约40%），只有27%的糖尿病患者参加过糖尿病学校。与以前调查的数据相比，心脏保护药物的使用有所增加，更多的患者正在实现危险因素治疗目标。尽管在患者管理方面取得了进展，但仍有进一步的潜力来改善糖尿病和冠状动脉疾病患者的检测和管理。
In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. A total of 6187 patients (18–80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012–2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. A total of 2846 (46 %) patients had no diabetes, 1158 (19 %) newly diagnosed diabetes and 2183 (35 %) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60 %, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54 % and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28 %. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0 % (53 mmol/mol) in 95 and 53 % and 11 % of those with previously known diabetes had an HbA1c >9.0 % (>75 mmol/mol). Of the patients with diabetes 69 % reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40 %) and only 27 % of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.