Nearly a quarter of patients with chronic ischemic cardiovascular disease are either dead or rehospitalized within six months of their diagnosis, according to a Jan. 17 report published in the European Journal of Preventive Cardiology.
“Coronary artery disease is the leading cause of death worldwide, yet some patients appear to get lost in the system after their initial visit to a hospital or outpatient clinic,” lead author Michel Komajda, MD, said in a release from the European Society of Cardiology. “These patients are at high risk of dying or being rehospitalized in the short-term and should be carefully monitored by physicians.”
Komajda and colleagues launched the Chronic Ischaemic Cardiovascular Disease Pilot Registry, a 2,420-patient strong database spanning 100 hospitals across 10 European countries. Enrolled patients had either stable coronary disease or peripheral artery disease—two of the most common cardiac conditions—and were followed for six months after seeing a health professional about their illnesses.
Of the 2,203 patients for whom follow-up data was available, 522 individuals, or 24 percent of the population, had died or been rehospitalized by the six-month mark. Death was more common in older patients who were rehospitalized and those who had a history of peripheral revascularization, chronic kidney disease or chronic obstructive pulmonary disease.
In addition, six-month rates were higher in eastern, western and northern European countries than southern ones—a phenomenon likely owed to the Mediterranean diet and lifestyle in the south, the authors wrote.
The team also found that commonly prescribed medications for preventing rehospitalization and death, like beta-blockers and angiotensin-converting enzyme inhibitors, were prescribed much less frequently after six months. The same was true for aspirin.
“In absolute numbers the reductions were modest, but they did reach statistical significance,” Komajda said. “This shows that patients have a better chance of receiving recommended medications while in hospital or directly after an outpatient appointment.”
Komajda et al.’s study didn’t focus on the reasons behind rarer prescriptions, but the researchers hypothesized the lowered medication intake could have something to do with affordability or patients going off-regimen.
“The study shows that patients with chronic ischaemic cardiovascular disease have a high risk of poor short-term outcomes,” Komajda said. “Yet some are not receiving recommended preventive medications, which could improve their outlook. More efforts are needed to ensure that these patients continue to be monitored and treated after they leave hospital or an outpatient appointment.”