Evidence map›Paper›PMID 29086252›Full record

ArticleInternational journal of behavioral medicine2018

Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients-Insights from the German Subset of the EUROASPIRE IV Survey.

Martin Wagner, Götz Gelbrich, Julia Kircher, Kornelia Kotseva, David Wood, Caroline Morbach, Rainer Leyh, Georg Ertl, Wolfgang Karmann, Stefan Störk and 1 more

Abstract read
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In one paragraph

Article in International journal of behavioral medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 14 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Observational
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 4 countries.

Martin WagnerInstitute of Clinical Epidemiology and Biometry, University of Würzburg, Petrinistr. 33a, 97080, Würzburg, Germany. wagner_m@ukw.de.ORCID http://orcid.org/0000-0002-9881-2722
Götz GelbrichInstitute of Clinical Epidemiology and Biometry, University of Würzburg, Petrinistr. 33a, 97080, Würzburg, Germany.
Julia KircherInstitute of Clinical Epidemiology and Biometry, University of Würzburg, Petrinistr. 33a, 97080, Würzburg, Germany.
Kornelia KotsevaDepartment of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
David WoodDepartment of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
Caroline MorbachComprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
Rainer LeyhComprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
Georg ErtlComprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
Wolfgang KarmannDepartment of Medicine, Klinik Kitzinger Land, Kitzingen, Germany.
Stefan StörkComprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
Peter U HeuschmannInstitute of Clinical Epidemiology and Biometry, University of Würzburg, Petrinistr. 33a, 97080, Würzburg, Germany.
University of Würzburg · DEGhent University · BEImperial College London · GBZimmer Biomet (Netherlands) · NL

Funding

Bundesministerium für Bildung und Forschung BMBF 01EO1004
6 · The paper itself

Abstract

purposeEvidence is limited on implementation of secondary prevention guidelines for coronary heart disease (CHD) in clinical practice and variations between younger and elder patients. We investigated the control of cardiovascular risk factors in German patients with CHD enrolled in the European-wide EUROASPIRE IV survey, stratified by younger (18-69 years) and older (70-79 years) age groups.

methodEligible subjects were identified via the hospitals' patient information system and invited to attend a study visit 6 months to 3 years after hospitalization for CHD (myocardial infarction, ischemia, angioplasty/stent, coronary bypass grafting). Information on lifestyle and medication was collected by interview.

resultsFive hundred thirty-six patients were recruited in 2012-2013 (median age 69 years [IQR 62-74 years], 18% female, 44% ≥ 70 years of age, median time between index hospitalization and study visit 1.8 [1.1-2.5] years). Proportion of CHD patients receiving recommended drug therapy was 89% for platelet inhibitors (younger vs. older patients 93 vs. 84%, p < 0.01), 83% for statins (83 vs. 85%, p = 0.9), and 83% for beta-blockers (87 vs. 79%, p = 0.02). Uncontrolled blood pressure was observed in 45% (40 vs. 50%, p = 0.02), LDL cholesterol levels > 2.5 mmol/l in 53% (56 vs. 49%, p = 0.1), and HbA1c levels > 7% in diabetic patients in 39% (45 vs. 32%, p = 0.1). Eighty-five percent were overweight (86 vs. 85%, p = 0.8), 37% were obese (41 vs. 31%, p = 0.01), and 10% reported currently smoking (17 vs. 3%, p < 0.01).

conclusionAlthough most CHD patients received the drug classes recommended by guidelines, treatment goals were frequently not achieved. Elderly subjects had a less favorable pattern, which may reflect multi-morbidity and weaker identification with treatment targets. National CHD prevention strategies should focus not only on enhancing lifestyle modifications and reaching treatment targets, but also on highlighting the different needs in older individuals.

Indexed as

Life StyleAdolescentAdultAgedBlood PressureCoronary DiseaseDiabetes MellitusFemaleHumansMaleMiddle AgedMorbidityObesityRisk FactorsSecondary PreventionSmokingCoronary heart diseaseElderlyEUROASPIRE surveyRisk factorsSecondary prevention

Identifiers

PMID29086252
OpenAlexW2765451826

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.