title: Secondary medical prevention and clinical outcome in coronary artery disease patients with a history of non-coronary vascular intervention: A report from the CORONOR investigators.
abstract: OBJECTIVE
  To assess the level of secondary prevention and the outcome of coronary artery disease (CAD) in patients who have a history of non-coronary vascular intervention.
  
  
  BACKGROUND
  Patients with polyvascular disease have been reported to receive less evidence-based medications, with worse risk factor control and to be at higher risk than patients with single-bed disease. It is unknown whether these findings remain valid in the modern era of secondary prevention.
  
  
  METHODS
  We included 4184 patients with stable CAD. Two groups were formed according to the absence (n = 3704) or presence (n = 480) of a history of non-coronary vascular intervention. Treatments and risk factor control were recorded at inclusion. Follow-up was performed after 2 years.
  
  
  RESULTS
  Antiplatelets, angiotensin system antagonists, beta-blockers and statins were widely prescribed in both groups. The number of antihypertensive drugs was higher in patients with non-coronary vascular intervention. Except for slight increases in the rate of current smokers and in systolic blood pressure, risk factor control was similar between groups. All-cause and cardiovascular mortality rates were higher in patients with non-coronary intervention with adjusted HR of 1.55 (1.13-2.13) (p = 0.007), and 1.98 (1.24-3.15) (p = 0.004), respectively.
  
  
  CONCLUSIONS
  In modern practice and real life conditions, the higher risk of CAD patients with a history of non-coronary vascular intervention is taken into account, with more intense secondary prevention and similar risk factor control than patients without such history. In spite of the level of secondary prevention, patients with a history of non-coronary vascular intervention remain at high risk of cardiovascular events. This should be an incentive to discuss more stringent objectives for secondary prevention in patients with polyvascular disease.
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Delsart
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Lille, France Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France Faculté de Médecine de Lille, Lille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Lemesle
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Lille, France Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France Faculté de Médecine de Lille, Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.affiliation: Centre Hospitalier de Dunkerque, Dunkerque, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Tricot
authors.affiliation: Polyclinique du Bois, Lille, France.
authors.forename: Thibaud
authors.initials: T
authors.lastname: Meurice
authors.affiliation: Centre Hospitalier de Béthune, Béthune, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Mycinski
authors.affiliation: Hôpital Privé de Villeneuve d'Ascq, Villeneuve d'Ascq, France.
authors.forename: Mariam
authors.initials: M
authors.lastname: Elkohen
authors.affiliation: Clinique de la Côte d'Opale, Boulogne-Sur-Mer, France.
authors.forename: Akram
authors.initials: A
authors.lastname: Chmait
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Lille, France Faculté de Médecine de Lille, Lille, France Inserm U1008, Université Lille Nord de France, Lille, France.
authors.forename: Stéphan
authors.initials: S
authors.lastname: Haulon
authors.affiliation: Centre Hospitalier Régional et Universitaire de Lille, Lille, France Inserm U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France Faculté de Médecine de Lille, Lille, France christophe.bauters@chru-lille.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002423:Cause of Death; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: Coronary artery disease; peripheral vascular disease; prognosis; risk factors; secondary prevention