scholarly journals Impact of Medication Adherence on Mortality and Cardiovascular Morbidity: Protocol for a Population-Based Cohort Study (Preprint)

2017 ◽  
Author(s):  
Maria Giner-Soriano ◽  
Gerard Sotorra Figuerola ◽  
Jordi Cortés ◽  
Helena Pera Pujadas ◽  
Ana Garcia-Sangenis ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Population Based ◽  
Cardiovascular Morbidity ◽  
Categorical Variables ◽  
Coronary Syndrome ◽  
Cardiovascular Morbidity And Mortality ◽  
Incident Cases

BACKGROUND Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, such as coronary heart disease (CHD), cerebrovascular disease, and peripheral artery disease. CVD is the leading threat to global health, whether measured by mortality, morbidity, or economic cost. Long-term administration of aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers improves survival in patients with stablished coronary heart disease. Nevertheless, adherence to prescribed medication is poor for long-term drug treatment. OBJECTIVE We aim to assess the relationship between adherences to the four pharmacological groups recommended for secondary prevention and the clinical outcomes of cardiovascular morbidity and mortality in patients with established CHD according to the level of adherence to these drugs in a population of incident cases of acute coronary syndrome (ACS). METHODS Population-based cohort study of patients with a first episode of ACS during 2006-2015 in the Information System for Research in Primary Care (SIDIAP) database. We will estimate adherence to these drugs. The primary endpoint is a composite of all-cause mortality, ACS, and ischaemic stroke. Bivariate analyses will be performed estimating odds ratios for categorical variables and mean differences for continuous variables. Hazard ratios for adherences will be calculated for outcome events using Cox proportional hazard regression models, and proportionality of hazards assumption will be tested. RESULTS We expect to estimate adherence to all four study treatments, the incidence of MACE, and to analyze if this incidence is associated with the level of drug adherence. CONCLUSIONS We expect to find that adherent patients have a lower risk of the primary endpoints compared with nonadherent patients. CLINICALTRIAL This study protocol was classified as EPA-OD by the AEMPS (IJG-EST-2017-01-2017-01, 07/04/2017) and registered in the EU PAS register (EUPAS19017, 09/05/2017).

Depression, antidepressants, and the risk of coronary heart disease: A population-based cohort study

2013 ◽  
Vol 168 (5) ◽  
pp. 4711-4716 ◽  
Author(s):  
Chun-Jen Huang ◽  
Ming-Hsiung Hsieh ◽  
Wen-Hsuan Hou ◽  
Ju-Chi Liu ◽  
Chii Jeng ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Population Based

Intensive Lipid-Lowering Therapy in Patients with Coronary Heart Disease

2005 ◽  
Vol 39 (2) ◽  
pp. 329-334 ◽  
Author(s):  
Stacy A Lauderdale ◽  
Amy Heck Sheehan
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Density Lipoprotein ◽  
Current Data ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
Cardiovascular Morbidity And Mortality ◽  
Stable Coronary Heart Disease

OBJECTIVE: To describe current data evaluating the use of intensive lipid-lowering therapy in patients with coronary heart disease. DATA SOURCES: A literature search using MEDLINE (1966–September 2004) was conducted using the search terms lipoproteins, low-density lipoprotein cholesterol (LDL-C), hydroxymethylglutaryl-coenzyme A reductase inhibitors, coronary arteriosclerosis, and coronary disease to identify published trials comparing the effects of intensive and conventional lipid-lowering therapy. DATA SYNTHESIS: Intensive lipid-lowering therapy reduces LDL-C levels significantly more than conventional treatment and appears to reduce cardiovascular morbidity and mortality in patients who have recently experienced acute coronary syndrome (ACS). However, evidence suggesting clinical benefits in patients with stable coronary heart disease is currently lacking. CONCLUSIONS: Although data are limited, patients with ACS may benefit from intensive lipid-lowering therapy. Several studies are underway to determine the appropriate role of intensive lipid-lowering therapy.

Cardiovascular morbidity and mortality in surgically treated hyperthyroidism - a nation-wide cohort study with a long-term follow-up

2013 ◽  
Vol 80 (5) ◽  
pp. 743-750 ◽  
Author(s):  
Essi Ryödi ◽  
Jorma Salmi ◽  
Pia Jaatinen ◽  
Heini Huhtala ◽  
Rauni Saaristo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Cardiovascular Morbidity And Mortality ◽  
Long Term Follow Up

Abstract P186: Circulating Desphospho-uncarboxylated Matrix Gla Protein and the Risk of Coronary Heart Disease and Stroke

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Geertje W Dalmeijer ◽  
Yvonne T van der Schouw ◽  
Elke J Magdeleyns ◽  
Cees Vermeer ◽  
W. Monique M Verschuren ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
General Population ◽  
Vitamin K ◽  
Stroke Risk ◽  
Matrix Gla Protein ◽  
Chd Risk ◽  
Increased Risk ◽  
Incident Cases

Background: Matrix Gla protein (MGP) is a vitamin K dependent protein and a potent inhibitor of vascular calcification. Desphospho-uncarboxylated MGP (dp-ucMGP) is a marker for vitamin K status with high dp-ucMGP concentration reflecting a low vitamin K status. High dp-ucMGP concentrations are thought to be associated with an increased risk of cardiovascular disease, but this has never been investigated in the general population. Objective: This study aimed to investigate the association of dp-ucMGP with incident coronary heart disease (CHD) or stroke in the general population. Design and Methods: A prospective case-cohort study with a representative baseline sample of 1406 participants and 1154 and 380 incident cases of CHD and stroke, respectively, was nested within the EPIC-NL study. Dp-ucMGP concentrations were measured by ELISA technique in baseline plasma samples. The incidence of fatal and non-fatal CHD and stroke was obtained by linkage to national registers. Cox proportional hazard models adapted for the case-cohort design were used to calculate hazard ratios (HRs) per standard deviation (SD) and per quartile of circulating dp-ucMGP levels, adjusted for cardiovascular risk factors. Results: This case-cohort study had an average follow-up of 11.5 years. Circulating dp-ucMGP levels were not associated with CHD risk with a HR per SD of 1.00 (95% CI: 0.93-1.07) and a HR Q4 vs Q1 of 0.94 (95% CI: 0.79-1.13) after multivariate adjustment. Circulating dp-ucMGP was not associated with stroke risk with a HR per SD of 0.98 (95% CI: 0.90-1.08) and a HR Q4 vs Q1 of 1.09 (95% CI: 0.78-1.51). Conclusion: This study does not support the hypothesis that high dp-ucMGP levels, reflecting a poor vitamin K status, are associated with increased CHD or stroke risk.

scholarly journals The Incidence of Coronary Heart Disease and the Population Attributable Fraction of Its Risk Factors in Tehran: A 10-Year Population-Based Cohort Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e105804 ◽  
Author(s):  
Davood Khalili ◽  
Farhad Haj Sheikholeslami ◽  
Mahmood Bakhtiyari ◽  
Fereidoun Azizi ◽  
Amir Abbas Momenan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Population Attributable Fraction ◽  
Population Based ◽  
Attributable Fraction
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