Document Detail


The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina.
MedLine Citation:
PMID:  15716284     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In order to assess adherence to guidelines and international variability in management, the Euro Heart Survey of Newly Presenting Angina prospectively studied medical therapy, percutaneous coronary intervention (PCI), and surgery in patients with new-onset stable angina in Europe. METHODS AND RESULTS: Consecutive patients, 3779 in total, with a clinical diagnosis of stable angina by a cardiologist were enrolled. After initial assessment by a cardiologist, 78% were treated with aspirin, 48% with a statin, and 67% with a beta-blocker. ACE-inhibitors were prescribed by the cardiologist in 37% overall. Revascularization rates were low, with only 501 (13%) patients having PCI or coronary bypass surgery performed or planned. However, when restricted to patients with coronary disease documented within 4 weeks of assessment, over 50% had revascularization performed or planned. Among other factors, the national rate of angiography and availability of invasive facilities significantly predicted the likelihood of revascularization, OR 2.4 and 2.0, respectively. CONCLUSION: This survey shows a shortfall between guidelines and practice with regard to the use of evidence-based drug therapy and evidence that revascularization rates are strongly influenced by non-clinical, in addition to clinical, factors.
Authors:
Caroline A Daly; Felicity Clemens; Jose L Lopez Sendon; Luigi Tavazzi; Eric Boersma; Nicholas Danchin; Francois Delahaye; Anselm Gitt; Desmond Julian; David Mulcahy; Witold Ruzyllo; Kristian Thygesen; Freek Verheugt; Kim M Fox;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2005-02-16
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-26     Completed Date:  2005-09-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1011-22     Citation Subset:  IM    
Affiliation:
Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. c.daly@rbh.nthames.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Angina Pectoris / prevention & control*
Angioplasty, Transluminal, Percutaneous Coronary / utilization
Cardiovascular Agents / therapeutic use*
Decision Making
Europe
Female
Guideline Adherence
Hospitalization
Humans
Male
Middle Aged
Myocardial Ischemia / prevention & control
Myocardial Revascularization / utilization*
Practice Guidelines as Topic
Prospective Studies
Referral and Consultation / statistics & numerical data
Regression Analysis
Chemical
Reg. No./Substance:
0/Cardiovascular Agents
Comments/Corrections
Comment In:
Eur Heart J. 2005 May;26(10):949-50   [PMID:  15829489 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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