Improving interMediAte Risk management. MARK study

BMC Cardiovascular Disorders

Study Protocol

Irene Sempere¹  Fernando Rigo¹  Natalia Feuerbach¹  Natividad García-Regalado¹  Jose I Recio-Rodriguez²  Manuel A Gómez-Marcos²  Cristina Agudo-Conde²  Luís García-Ortiz²  Maria Garcia-Gil³  Ruth Martí⁴  Dídac Parramon⁴  Anna Ponjoan⁴  Rafel Ramos⁵  Miquel Quesada⁵ 

[1] CS San Agustín, Gerencia Atención Primaria Ibsalut, C/Nicolau Alemany 1, Palma de Mallorca, 07015, Spain;Unidad de Investigación de Atención Primaria La Alamedilla, Centro de Salud La Alamedilla, Av Comuneros 27-31, 37003, Salamanca, Spain;Unitat d'Investigació en Atenció Primària de Girona, IDIAP Jordi Gol, Institut Català de la Salut, C/Maluquer Salvador, 11, 17071, Girona, Spain;Departament de Ciències Mèdiques, Facultat de Medicina Universitat de Girona, Campus de Montilivi, 17071, Girona, Spain;Unitat d'Investigació en Atenció Primària de Girona, IDIAP Jordi Gol, Institut Català de la Salut, C/Maluquer Salvador, 11, 17071, Girona, Spain;Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Av. de França s/n, 17007, Girona, Spain;Unitat d'Investigació en Atenció Primària de Girona, IDIAP Jordi Gol, Institut Català de la Salut, C/Maluquer Salvador, 11, 17071, Girona, Spain;Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Av. de França s/n, 17007, Girona, Spain;Departament de Ciències Mèdiques, Facultat de Medicina Universitat de Girona, Campus de Montilivi, 17071, Girona, Spain;

关键词: Risk assessment;    cardiovascular diseases;    primary prevention;    primary health care.;   

DOI  :  10.1186/1471-2261-11-61

 received in 2011-09-08, accepted in 2011-10-13,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundCardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.Methods/DesignThis project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors.DiscussionPrimary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect.Trial RegistrationClinical Trials.gov Identifier: NCT01428934

【 授权许可】

Unknown   
© Martí et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.