Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart

BMC Cardiovascular Disorders

Research

Ben Schöttker¹  Ute Mons²  Hermann Brenner³  Martin Rehm⁴  Andrea Jaensch⁴  Wolfgang Koenig⁵  Dietrich Rothenbacher⁶  Harry Hahmann⁷ 

[1] Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumour Diseases (NCT), Heidelberg, Germany;German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany;Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany;Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany;Deutsches Herzzentrum München, Technische Universität München, Munich, Germany;German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany;Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany;Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;Klinik Schwabenland, Isny-Neutrauchburg, Isny, Germany;

关键词: Chronic coronary syndrome;    Cardiac rehabilitation;    Risk factors;    Biomarkers;    Pharmacological treatment;    Mortality;   

DOI  :  10.1186/s12872-023-03469-4

 received in 2023-06-02, accepted in 2023-08-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThis study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart.MethodsThe KAROLA cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009–2011). Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline, at the end of rehabilitation, and after one year of follow-up. A biomarker-based risk model (ABC-CHD model) and Cox regression analysis were used to evaluate cardiovascular (CV) and non-CV mortality risk.ResultsWe included 1130 patients from KAROLA-I (mean age 58.7 years, 84.4% men) and 860 from KAROLA-II (mean age 60.4 years, 83.4% men). Patients in the KAROLA-I cohort had significantly higher concentrations of CV biomarkers and fewer patients were taking CV medications, except for statins. The biomarker-based ABC-CHD model provided a higher estimate of CV death risk for patients in the KAROLA-I cohort (median 3-year risk, 3.8%) than for patients in the KAROLA-II cohort (median 3-year risk, 2.7%, p-value for difference < 0.001). After 10 years of follow-up, 91 (8.1%) patients in KAROLA-I and 45 (5.2%) in KAROLA-II had died from a CV event.ConclusionsAdvances in disease management over the past 20 years may have led to modest improvements in pharmacological treatment during cardiac rehabilitation and long-term outpatient care for patients with CCS. However, modifiable risk factors such as obesity have increased in the more recent cohort and should be targeted to further improve the prognosis of these patients.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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