Prognosis at 6 months for coronary and cerebrovascular patients: impact of antiplatelet agents and statins: results from the Prevenir III study.
OBJECTIVE
The aim of the Prevenir III study was to assess, in secondary prevention, the risk after 6 months of subsequent coronary and cerebrovascular events in a population of patients in private practice.


METHODS
A prospective observational survey, including patients diagnosed with previous myocardial infarction, unstable angina or stroke, was carried out by French general practitioners and cardiologists.


RESULTS
9556 patients were selected by 3746 physicians representative of French physicians. The medical records of 8288 were analyzed. After a 6-month follow-up, 116 patients (1.4%) had been hospitalized for coronary or cerebrovascular event i.e. cumulative incidence 3.6 per 100 person-years (95% CI 2.9-4.2). The rate of coronary events was 0.9% and the cumulative incidence 2.3% person-years (95% CI 1.8-2.8), the event rate of stroke was 0.5% and the cumulative incidence 1.3 person-years (95% CI 0.9-1.7) and all-cause mortality was 1.2% i.e. 3.1 per 100 person-years (95% CI 2.5-3.7). Patients treated with statins and antiplatelet agents, or both, were less likely to undergo subsequent events than patients not receiving statins or antiplatelet agents. All-cause mortality rate decreased dramatically (Hazard Ratio 0.4 95% CI 0.2-0.7 after adjustment for age, sex, diagnosis at inclusion, time elapsed since the index event, cardiovascular and non cardiovascular history, betablockers, angiotensin-converting enzyme inhibitors and cardiovascular risk factors) in patients treated with a combination of statins and antiplatelet agents when compared to patients treated with neither statins nor antiplatelet agents.


CONCLUSIONS
Our survey enabled a better understanding of the prognosis at 6 months in a large sample of coronary and cerebrovascular patients. We observed the beneficial impact of the combination of statins and antiplatelet agents in cardiovascular secondary prevention.
Ferrières
Jean
J
Unité de Prévention de l'Athérosclérose, Service de cardiologie B, CHU Rangueil, 31059, Toulouse cedex 9, France. jean.ferrieres@cict.fr
Cambou
Jean-Pierre
JP
Cantet
Christelle
C
Guize
Louis
L
D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D003327:Coronary Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011331:Private Practice; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D055502:Secondary Prevention; D016019:Survival Analysis
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors