Browsing by Author "Pogosova, N"
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- Exercise-Based Cardiac Rehabilitation in Twelve European Countries Results of the European Cardiac Rehabilitation RegistryPublication . Benzer, W; Rauch, B; Schmid, JP; Zwisler, A; Dendale, P; Davos, C; Koudi, E; Simon, A; Abreu, A; Pogosova, N; Gaita, D; Miletic, B; Bönner, G; Ouarrak, T; McGee, HAIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR differed between countries being predominantly ACS in Switzerland (79%), Portugal (62%) and Germany (61%), elective PCI in Greece (37%), Austria (36%) and Spain (32%), and CABG in Croatia and Russia (36%). A minority of patients presented with chronic heart failure (4%). At CR start, most patients already were under medication according to current guidelines for the treatment of CV risk factors. A wide range of CR programme designs was found (duration 3 to 24weeks; total number of sessions 30 to 196). Patient programme adherence after admission was high (85%). With reservations that eCRF follow-up data exchange remained incomplete, patient CV risk profiles experienced only small improvements. CR success as defined by an increase of exercise capacity >25W was significantly higher in young patients and those who were employed. Results differed by countries. After CR only 9% of patients were admitted to a structured post-CR programme. CONCLUSIONS: Clinical characteristics of CR patients, indications and programmes in Europe are different. Guideline adherence is poor. Thus, patient selection and CR programme designs should become more evidence-based. Routine eCRF documentation of CR results throughout European countries was not sufficient in its first application because of incomplete data exchange. Therefore better adherence of CR centres to minimal routine clinical standards is requested.
- Lifestyle and Impact on Cardiovascular Risk Factor Control in Coronary Patients Across 27 Countries: Results From the European Society of Cardiology ESC-EORP EUROASPIRE V RegistryPublication . Kotseva, K; De Backer, G; De Bacquer, D; Rydén, L; Hoes, A; Grobbee, D; Maggioni, A; Marques-Vidal, P; Jennings, C; Abreu, A; Aguiar, C; Badariene, J; Bruthans, J; Castro Conde, A; Cifkova, R; Crowley, J; Davletov, K; Deckers, J; De Smedt, D; De Sutter, J; Dilic, M; Dolzhenko, M; Dzerve, V; Erglis, A; Fras, Z; Gaita, D; Gotcheva, N; Heuschmann, P; Hasan-Ali, H; Jankowski, P; Lalic, N; Lehto, S; Lovic, D; Mancas, S; Mellbin, L; Milicic, D; Mirrakhimov, E; Oganov, R; Pogosova, N; Reiner, Z; Stöerk, S; Tokgözoğlu, L; Tsioufis, C; Vulic, D; Wood, DAims: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods: Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results: A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.
- Lifestyle and Risk Factor Management in People at High Risk of Cardiovascular Disease. A Report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV Cross-Sectional Survey in 14 European RegionsPublication . Kotseva, K; De Bacquer, D; De Backer, G; Rydén, L; Jennings, C; Gyberg, V; Abreu, A; Aguiar, C; Conde, Almudena C; Davletov, K; Dilic, M; Dolzhenko, M; Gaita, D; Georgiev, B; Gotcheva, N; Lalic, N; Laucevicius, A; Lovic, D; Mancas, S; Miličić, D; Oganov, R; Pajak, A; Pogosova, N; Reiner, Ž; Vulic, D; Wood, D; The Euroaspire InvestigatorsBACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practice. METHODS: Patients without a history of atherosclerotic disease started on either blood pressure and/or lipid and/or glucose-lowering treatments were identified and interviewed at least six months after the start of medication. RESULTS: Medical notes of 6700 patients were reviewed, and 4579 patients (58.7% women; mean age 58.8 (standard deviation (SD) 11.3) years) interviewed (interview rate 68.3%). Overall, 16.6% were smokers, 39.9% were overweight (body mass index (BMI)≥25 and <30 kg/m2), 43.5% obese (BMI ≥30 kg/m2) and 63.9% centrally obese (waist circumference of ≥88 cm for women, ≥102 cm for men). The medical risk factor control was very poor, with less than half (42.8%) of the patients on blood pressure lowering medication reaching the target of <140/90 mm Hg (<140/80 mm Hg in people with self-reported diabetes). Among treated dyslipidaemic patients only 32.7% attained the low-density lipoprotein (LDL)-cholesterol target of <2.5 mmol/l. Among people treated for type 2 diabetes mellitus, 58.5% achieved the glycated haemoglobin (HbA1c) target of <7.0%. CONCLUSION: The EUROASPIRE IV survey shows that large proportions of patients at high CVD risk have unhealthy lifestyle habits and uncontrolled blood pressure, lipids and diabetes. The present data make it clear that more efforts must be taken to improve cardiovascular prevention in people at high CVD risk.