TY - JOUR
T1 - Thirteen-Year Trends in Cardiovascular Risk in Men and Women with Chronic Coronary Syndrome
AU - Olesen, Kevin Kris Warnakula
AU - Jensen, Esben Skov
AU - Gyldenkerne, Christine
AU - Würtz, Morten
AU - Mortensen, Martin Bødtker
AU - Nørgaard, Bjarne Linde
AU - Sørensen, Henrik Toft
AU - Bøtker, Hans Erik
AU - Maeng, Michael
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions please email: [email protected].
PY - 2022/7
Y1 - 2022/7
N2 - Aims: To examine combined and sex-specific temporal changes in risks of adverse cardiovascular events and coronary revascularization in patients with chronic coronary syndrome undergoing coronary angiography. Methods and results: We included all patients with stable angina pectoris and coronary artery disease examined by coronary angiography in Western Denmark from 2004 to 2016. Patients were stratified by examination year interval: 2004-2006, 2007-2009, 2010-2012, and 2013-2016. Outcomes were 2-year risk of myocardial infarction, ischaemic stroke, cardiac death, and all-cause death estimated by adjusted incidence rate ratios using patients examined in 2004-2006 as reference. A total of 29 471 patients were included, of whom 70% were men. The 2-year risk of myocardial infarction [2.8% vs. 1.9%, adjusted incidence rate ratio 0.65, 95% confidence interval (CI) 0.53-0.81], ischaemic stroke (1.8% vs. 1.1%, adjusted incidence rate ratio 0.48, 95% CI 0.37-0.64), cardiac death (2.1% vs. 0.9%, adjusted incidence rate ratio 0.38, 95% CI 0.29-0.51), and all-cause death (5.0% vs. 3.6%, adjusted incidence rate ratio 0.65, 95% CI 0.55-0.76) decreased from the first examination interval (2004-2006) to the last examination interval (2013-2016). Coronary revascularizations also decreased (percutaneous coronary intervention: 51.6% vs. 42.5%; coronary artery bypass grafting: 24.6% vs. 17.5%). Risk reductions were observed in both men and women, however, women had a lower absolute risk. Conclusion: The risk for adverse cardiovascular events decreased substantially in both men and women with chronic coronary syndrome from 2004 to 2016. These results most likely reflect the cumulative effect of improvements in the management of chronic coronary artery disease.
AB - Aims: To examine combined and sex-specific temporal changes in risks of adverse cardiovascular events and coronary revascularization in patients with chronic coronary syndrome undergoing coronary angiography. Methods and results: We included all patients with stable angina pectoris and coronary artery disease examined by coronary angiography in Western Denmark from 2004 to 2016. Patients were stratified by examination year interval: 2004-2006, 2007-2009, 2010-2012, and 2013-2016. Outcomes were 2-year risk of myocardial infarction, ischaemic stroke, cardiac death, and all-cause death estimated by adjusted incidence rate ratios using patients examined in 2004-2006 as reference. A total of 29 471 patients were included, of whom 70% were men. The 2-year risk of myocardial infarction [2.8% vs. 1.9%, adjusted incidence rate ratio 0.65, 95% confidence interval (CI) 0.53-0.81], ischaemic stroke (1.8% vs. 1.1%, adjusted incidence rate ratio 0.48, 95% CI 0.37-0.64), cardiac death (2.1% vs. 0.9%, adjusted incidence rate ratio 0.38, 95% CI 0.29-0.51), and all-cause death (5.0% vs. 3.6%, adjusted incidence rate ratio 0.65, 95% CI 0.55-0.76) decreased from the first examination interval (2004-2006) to the last examination interval (2013-2016). Coronary revascularizations also decreased (percutaneous coronary intervention: 51.6% vs. 42.5%; coronary artery bypass grafting: 24.6% vs. 17.5%). Risk reductions were observed in both men and women, however, women had a lower absolute risk. Conclusion: The risk for adverse cardiovascular events decreased substantially in both men and women with chronic coronary syndrome from 2004 to 2016. These results most likely reflect the cumulative effect of improvements in the management of chronic coronary artery disease.
KW - Chronic coronary syndrome
KW - Coronary angiography
KW - Ischaemic stroke
KW - Myocardial infarction
KW - FRACTIONAL FLOW RESERVE
KW - HEART
KW - METAANALYSIS
KW - STENOSIS
KW - MYOCARDIAL-INFARCTION
KW - INTERVENTION
KW - REGISTRY
KW - Myocardial Infarction/epidemiology
KW - Brain Ischemia
KW - Cardiovascular Diseases
KW - Humans
KW - Risk Factors
KW - Coronary Artery Disease/epidemiology
KW - Male
KW - Ischemic Stroke
KW - Death
KW - Female
KW - Stroke/epidemiology
KW - Heart Disease Risk Factors
U2 - 10.1093/ehjqcco/qcab015
DO - 10.1093/ehjqcco/qcab015
M3 - Journal article
C2 - 33629103
SN - 2058-1742
VL - 8
SP - 437
EP - 446
JO - European heart journal - Quality of care & clinical outcomes
JF - European heart journal - Quality of care & clinical outcomes
IS - 4
ER -