Long-term outcomes of chronic coronary syndrome worldwide: insights from the international CLARIFY registry

Sorbets, E. et al. (2020) Long-term outcomes of chronic coronary syndrome worldwide: insights from the international CLARIFY registry. European Heart Journal, 41(3), pp. 347-356. (doi: 10.1093/eurheartj/ehz660) (PMID:31504434) (PMCID:PMC6964227)

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Abstract

Aims: Over the last decades, the profile of chronic coronary syndrome has changed substantially. We aimed to determine characteristics and management of patients with chronic coronary syndrome in the contemporary era, as well as outcomes and their determinants. Methods and results: Data from 32 703 patients (45 countries) with chronic coronary syndrome enrolled in the prospective observational CLARIFY registry (November 2009 to June 2010) with a 5-year follow-up, were analysed. The primary outcome [cardiovascular death or non-fatal myocardial infarction (MI)] 5-year rate was 8.0% [95% confidence interval (CI) 7.7–8.3] overall [male 8.1% (7.8–8.5); female 7.6% (7.0–8.3)]. A cox proportional hazards model showed that the main independent predictors of the primary outcome were prior hospitalization for heart failure, current smoking, atrial fibrillation, living in Central/South America, prior MI, prior stroke, diabetes, current angina, and peripheral artery disease. There was an interaction between angina and prior MI (P = 0.0016); among patients with prior MI, angina was associated with a higher primary event rate [11.8% (95% CI 10.9–12.9) vs. 8.2% (95% CI 7.8–8.7) in patients with no angina, P < 0.001], whereas among patients without prior MI, event rates were similar for patients with [6.3% (95% CI 5.4–7.3)] or without angina [6.4% (95% CI 5.9–7.0)], P > 0.99. Prescription rates of evidence-based secondary prevention therapies were high. Conclusion: This description of the spectrum of chronic coronary syndrome patients shows that, despite high rates of prescription of evidence-based therapies, patients with both angina and prior MI are an easily identifiable high-risk group who may deserve intensive treatment. Clinical registry: ISRCTN43070564.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Greenlaw, Miss Nicola and Kalra, Dr Paul and Ford, Professor Ian
Authors: Sorbets, E., Fox, K. M., Elbez, Y., Danchin, N., Dorian, P., Ferrari, R., Ford, I., Greenlaw, N., Kalra, P. R., Parma, Z., Shalnova, S., Tardif, J.-C., Tendera, M., Zamorano, J. L., Vidal-Petiot, E., and Steg, P. G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Heart Journal
Publisher:Oxford University Press
ISSN:0195-668X
ISSN (Online):1522-9645
Published Online:03 September 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in European Heart Journal 41(3): 347-356
Publisher Policy:Reproduced under a Creative Commons License

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