Predictive value of classical risk factors and their control in coronary patients: a follow-up of the EUROASPIRE I cohort.
BACKGROUND
Both EUROASPIRE studies revealed the suboptimal management of coronary patients regarding lifestyle changes and prophylactic use of cardiovascular drugs. We report here on the mortality follow-up of the EUROASPIRE I cohort over a median period of 4.4 years.


METHODS
The EUROASPIRE I cohort consisted of a consecutive sample of patients aged < or =70 years from nine European countries, hospitalized because of coronary artery bypass graft, percutaneous transluminal coronary angioplasty, acute myocardial infarction or myocardial ischaemia. Baseline data, gathered in 1995-96 through standardized methods, were linked to cause-specific mortality as registered up to 1 April 2000 in 3343 patients.


RESULTS
After adjustment for age, gender and diagnostic category according to Cox modelling, smoking, previous coronary heart disease and diabetes proved significant predictors of total, cardiovascular (CVD) and coronary heart disease (CHD) mortality. Obesity, low education, raised blood pressure, elevated total cholesterol and low HDL cholesterol, however, were not significantly associated with higher mortality rates. In multivariate analysis, smoking and diabetes emerged as the strongest predictors of CVD [risk ratios (RR) 2.2 and 2.5 respectively] and CHD mortality (RR 2.4 and 2.4 respectively).


CONCLUSIONS
The results of the mortality follow-up of the EUROASPIRE I patients underline the importance of smoking and diabetes in the secondary prevention of CHD. Failure to find statistically significant associations between other classical risk factors, such as blood pressure and plasma lipid levels, and mortality may be related to the extensive use of antihypertensive and lipid-lowering drugs in this cohort.
De Bacquer
Dirk
D
Department of Public Health, Ghent University, Belgium. dirk.debacquer@ugent.be
De Backer
Guy
G
Ostör
Erika
E
Simon
Jaroslav
J
Pyörälä
Kalevi
K
D000328:Adult; D000368:Aged; D001519:Behavior; D015331:Cohort Studies; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000517:prevention & control*; D006973:Hypertension / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors