Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 31 n° 321

Posts Tagged ‘hospitalisation’

More than half of heart patients continue smoking after hospitalisation

Posted by fidest press agency su martedì, 24 aprile 2018

Ljubljana, Slovenia More than half of heart patients continue smoking after hospitalisation, according to results of the EUROASPIRE V survey presented today at EuroPrevent 2018, a European Society of Cardiology congress.1 Nearly half of obese patients have no plans for weight loss.EUROASPIRE is a series of cross sectional surveys on cardiovascular prevention in Europe that are conducted under the ESC’s EORP initiative.2 EUROASPIRE V examined cardiovascular risk factors in 8,261 patients with established coronary heart disease from 27 countries during June 2016 to September 2018. Patients were interviewed and clinically examined six months to two years (median 1.12 years) after hospitalisation for an acute coronary event or coronary revascularisation.
Nearly one in four patients (26%) in the study were women, the average age of all study participants was 64 years, and one-third were under 60 years old.
One year after their heart attack, more than half (55%) of the patients who were smokers before hospitalisation were still smoking (almost one-fifth of all study participants)Professor Kornelia Kotseva, chair of the EUROASPIRE Steering Committee from Imperial College London, UK, said: “Smoking is still a major problem in patients who have been hospitalised for heart disease, especially in younger patients.” Some 38% of patients were obese (body mass index 30kg/m2 or higher), with levels ranging from 16% in Serbia to 47% in Lithuania. Of those who were obese, 45% had no plans for weight loss and 25% had never been told they had a weight problem. More than half of patients (59%) were centrally obese (waist circumference 88 cm or greater in women and 102 cm or greater in men).
The prevalence of high blood pressure (140/90 mmHg or above, and 140/80 mmHg or above in patients with diabetes) was 46% (range 31–57%), while 12% of patients had blood pressure 160/100 mmHg or above. Antihypertensive drugs were used in 78% of patients (range 49–83%), of whom 49% had controlled blood pressure (less than 140/90 mmHg, and less than 140/80 mmHg in patients with diabetes).Some 29% of patients reported that they had diabetes, but only 54% of these patients had HbA1c less than 7%, meaning their diabetes was well controlled. In addition to those with known diabetes, an oral glucose tolerance test revealed that 12% of patients had newly detected diabetes, 18% had impaired glucose tolerance, and 10% had impaired fasting glycaemia.Less than half (46%) of patients had been advised to attend cardiac rehabilitation programmes (range 0–84%), and only 32% attended at least half of the sessions. Professor Kotseva said: “Some countries do not have any programmes on secondary prevention and rehabilitation while in others they are standard practice. Most patients follow advice to attend such programmes so the challenge is to achieve wider availability and access for all patients across Europe.”
Professor David A. Wood, Principal Investigator of EUROASPIRE from Imperial College London, said multidisciplinary, comprehensive prevention programmes were needed for all patients with coronary heart disease. He said: “We need multidisciplinary teams to address lifestyle, risk factor management and the effective use of cardioprotective drug therapies.” (Authors: ESC Press Office)

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Alcohol related hospitalisation is associated with a doubled risk of ischaemic stroke risk in patients with non-valvular atrial fibrillation

Posted by fidest press agency su domenica, 28 agosto 2016

cardiology congress-2016Rome, Italy According to a study presented at ESC Congress 2016 today by Dr Faris Al-Khalili, cardiologist, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. The observational study was conducted in more than 25 000 non-valvular atrial fibrillation patients at low risk of stroke. “Atrial fibrillation (AF) is the most common heart rhythm disturbance and is associated with a five-fold increased risk of ischaemic stroke,” said Dr Al-Khalili. “AF is also associated with increased mortality, reduced quality of life and a higher risk of heart failure.”Treatment with oral anticoagulants reduces the risk of stroke and is recommended according to the number of stroke risk factors. Risk is estimated using the CHA2DS2-VASc score which gives points for clinical risk factors.(3) Patients with non-valvular AF under the age of 65 and a score of 0 in men or 1 in women are considered to be at low risk for ischaemic stroke, and oral anticoagulation therapy is not indicated.Dr Al-Khalili said: “Even if the risk for stroke is low, it is not negligible, and a number of such ‘low risk’ patients do present with ischaemic stroke in clinical practice and in patient registers.” The objective of this study was to assess the incidence and predictors of ischaemic stroke among low risk patients with non-valvular AF. This retrospective study included 25 252 low risk non-valvular AF patients (age 18–64) out of a total of 345 123 AF patients identified from the Swedish nationwide Danderyd Hospitalpatient register for the period 1 January 2006 to 31 December 2012. The median age was 55 years and 72% were men.The patient register holds information about all hospitalisations and visits to hospital-affiliated open clinics in Sweden. Socioeconomic variables were obtained from a database for health insurance and labour market studies. Information about current medication was obtained from the National Drug Register, which has information about all dispensed prescription in Sweden and is 100% complete.During a median follow-up of five years, ischaemic stroke occurred at an annual rate of 3.4 per 1000 patient-years. The overall mortality was 7.5 per 1000 patient-years in patients without ischaemic stroke, and 29.6 per 1000 patient-years in patients who had suffered an ischaemic stroke during follow-up.In the multivariable analysis, the only variables that remained significantly associated with an increased risk of ischaemic stroke were age (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.05–1.08, p Dr Al-Khalili concluded: “Doctors should ask their AF patients about alcohol use and advise patients to cut down if they are drinking more than is recommended. The beneficial link between oral anticoagulant use and ischaemic stroke in this low risk population without a recognised indication for these drugs needs further investigation, including the benefit to harm (bleeding) ratio.”

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