Abstract
BackgroundIn order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines.MethodsA total of 6187 patients (18–80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012–2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys.ResultsA total of 2846 (46 %) patients had no diabetes, 1158 (19 %) newly diagnosed diabetes and 2183 (35 %) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60 %, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54 % and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28 %. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0 % (53 mmol/mol) in 95 and 53 % and 11 % of those with previously known diabetes had an HbA1c >9.0 % (>75 mmol/mol). Of the patients with diabetes 69 % reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40 %) and only 27 % of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets.ConclusionsDespite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.
Highlights
In order to influence every day clinical practice professional organisations issue management guidelines
Men and women aged ≥18 to
A total of 16,426 medical records were reviewed in the search for study participants and 7998 (49 %) attended the Glucose lowering treatment Sixty five per cent of the patients with previously known diabetes had been given dietary advice
Summary
In order to influence every day clinical practice professional organisations issue management guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. The management of patients with coronary artery disease has since long been the subject of such guidelines. One third of patients with coronary artery disease have diabetes, a rapidly growing disease globally [1,2,3]. Patients with both diagnoses have a considerably higher mortality than coronary patients without diabetes [4, 5]. Still preventive management of cardiovascular patients, especially those with diabetes, remains inadequate [6,7,8]
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