Management strategies and 5-year outcomes in Polish patients with stable coronary artery disease versus other European countries: data from the CLARIFY registry

Parma, Z., Young, R. , Roleder, T., Marona, M., Ford, I. , Tendera, M., Steg, P. G. and Stępińska, J. (2019) Management strategies and 5-year outcomes in Polish patients with stable coronary artery disease versus other European countries: data from the CLARIFY registry. Polish Archives of Internal Medicine, 129(5), pp. 327-334. (doi: 10.20452/pamw.14789) (PMID:30951032)

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Abstract

Introduction: An international registry of ambulatory patients with stable coronary artery disease (CLARIFY) allows a comparison of management and outcomes in real-life setting. Objectives: We aimed to compare the management strategies and 5-year outcomes in patients from Poland and from other European countries. Patients and methods: Stable coronary artery disease was defined as previous myocardial infarction (MI) or revascularization, coronary stenosis greater than 50%, or documented symptomatic myocardial ischemia. Patients were followed on an annual basis for 5 years. Results: Among the total of 32703 patients, 1000 were enrolled in Poland, and 17326 in other European countries. Polish patients were younger, with a higher proportion of women, smokers, and patients with previous MI, dyslipidemia, and hypertension. Patients in both cohorts received adequate medical treatment, with more Polish patients receiving β-blockers. Blood pressure and lipid control to target was similar and remained low in both cohorts. Diabetes control and successful smoking cessation rates were lower in Poland than in other European countries. Polish patients more often underwent percutaneous coronary intervention. All-cause (8.5% vs 7.9%; P = 0.81) and cardiovascular death rates (5.3% vs 4.9%; P = 0.82) did not differ between the groups, but fatal or nonfatal MI occurred more often in the Polish cohort (5% vs 3.1%; P = 0.006). Angina control was better in Poland than in other European countries (Canadian Cardiovascular Society class II-IV, 11.5% vs 15.8% of patients; P <0.001). Conclusions: Risk factor control was insufficient both in patients from Poland and in those from other European countries. The more frequent use of revascularization in Polish patients was not linked to improved outcomes, but, together with more extensive prescription of β-blockers, might have contributed to better angina control.

Item Type:Articles
Additional Information:The CLARIFY registry was designed and conduct‑ ed by investigators and funded by grants from Servier.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ford, Professor Ian and Young, Dr Robin
Authors: Parma, Z., Young, R., Roleder, T., Marona, M., Ford, I., Tendera, M., Steg, P. G., and Stępińska, J.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Polish Archives of Internal Medicine
Publisher:Medycyna Praktyczna
ISSN:1897-9483
ISSN (Online):1897-9483
Copyright Holders:Copyright © 2019 Medycyna Praktyczna
First Published:First published in Polish Archives of Internal Medicine 129(5):327-334
Publisher Policy:Reproduced under a Creative Commons License

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