Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart
Abstract Background This study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart. Methods The KAROLA cohorts included patients...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03469-4 |
| _version_ | 1797578289213079552 |
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| author | Martin Rehm Andrea Jaensch Ben Schöttker Ute Mons Harry Hahmann Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher |
| author_facet | Martin Rehm Andrea Jaensch Ben Schöttker Ute Mons Harry Hahmann Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher |
| author_sort | Martin Rehm |
| collection | DOAJ |
| description | Abstract Background This study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart. Methods The KAROLA cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009–2011). Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline, at the end of rehabilitation, and after one year of follow-up. A biomarker-based risk model (ABC-CHD model) and Cox regression analysis were used to evaluate cardiovascular (CV) and non-CV mortality risk. Results We included 1130 patients from KAROLA-I (mean age 58.7 years, 84.4% men) and 860 from KAROLA-II (mean age 60.4 years, 83.4% men). Patients in the KAROLA-I cohort had significantly higher concentrations of CV biomarkers and fewer patients were taking CV medications, except for statins. The biomarker-based ABC-CHD model provided a higher estimate of CV death risk for patients in the KAROLA-I cohort (median 3-year risk, 3.8%) than for patients in the KAROLA-II cohort (median 3-year risk, 2.7%, p-value for difference < 0.001). After 10 years of follow-up, 91 (8.1%) patients in KAROLA-I and 45 (5.2%) in KAROLA-II had died from a CV event. Conclusions Advances in disease management over the past 20 years may have led to modest improvements in pharmacological treatment during cardiac rehabilitation and long-term outpatient care for patients with CCS. However, modifiable risk factors such as obesity have increased in the more recent cohort and should be targeted to further improve the prognosis of these patients. |
| first_indexed | 2024-03-10T22:20:48Z |
| format | Article |
| id | doaj.art-eaf60b533abb4769bdeb06e27933193b |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-10T22:20:48Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-eaf60b533abb4769bdeb06e27933193b2023-11-19T12:18:30ZengBMCBMC Cardiovascular Disorders1471-22612023-08-0123111010.1186/s12872-023-03469-4Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apartMartin Rehm0Andrea Jaensch1Ben Schöttker2Ute Mons3Harry Hahmann4Wolfgang Koenig5Hermann Brenner6Dietrich Rothenbacher7Institute of Epidemiology and Medical Biometry, Ulm UniversityInstitute of Epidemiology and Medical Biometry, Ulm University Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ) Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ)Klinik Schwabenland, Isny-NeutrauchburgInstitute of Epidemiology and Medical Biometry, Ulm University Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ)Institute of Epidemiology and Medical Biometry, Ulm UniversityAbstract Background This study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart. Methods The KAROLA cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009–2011). Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline, at the end of rehabilitation, and after one year of follow-up. A biomarker-based risk model (ABC-CHD model) and Cox regression analysis were used to evaluate cardiovascular (CV) and non-CV mortality risk. Results We included 1130 patients from KAROLA-I (mean age 58.7 years, 84.4% men) and 860 from KAROLA-II (mean age 60.4 years, 83.4% men). Patients in the KAROLA-I cohort had significantly higher concentrations of CV biomarkers and fewer patients were taking CV medications, except for statins. The biomarker-based ABC-CHD model provided a higher estimate of CV death risk for patients in the KAROLA-I cohort (median 3-year risk, 3.8%) than for patients in the KAROLA-II cohort (median 3-year risk, 2.7%, p-value for difference < 0.001). After 10 years of follow-up, 91 (8.1%) patients in KAROLA-I and 45 (5.2%) in KAROLA-II had died from a CV event. Conclusions Advances in disease management over the past 20 years may have led to modest improvements in pharmacological treatment during cardiac rehabilitation and long-term outpatient care for patients with CCS. However, modifiable risk factors such as obesity have increased in the more recent cohort and should be targeted to further improve the prognosis of these patients.https://doi.org/10.1186/s12872-023-03469-4Chronic coronary syndromeCardiac rehabilitationRisk factorsBiomarkersPharmacological treatmentMortality |
| spellingShingle | Martin Rehm Andrea Jaensch Ben Schöttker Ute Mons Harry Hahmann Wolfgang Koenig Hermann Brenner Dietrich Rothenbacher Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart BMC Cardiovascular Disorders Chronic coronary syndrome Cardiac rehabilitation Risk factors Biomarkers Pharmacological treatment Mortality |
| title | Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| title_full | Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| title_fullStr | Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| title_full_unstemmed | Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| title_short | Medical care and biomarker-based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| title_sort | medical care and biomarker based assessment of mortality in two cohorts of patients with chronic coronary syndrome 10 years apart |
| topic | Chronic coronary syndrome Cardiac rehabilitation Risk factors Biomarkers Pharmacological treatment Mortality |
| url | https://doi.org/10.1186/s12872-023-03469-4 |
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