Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice

Abstract

IntroductionAlthough atherosclerotic disease cannot be cured, risk of recurrent events can be reduced by application of evidence-based treatment protocols involving aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statin medications. We studied atherosclerotic event rates in a patient population treated before and after the development of aggressive risk factor reduction treatment protocols.Material and methodsWe performed a retrospective chart review of patients presenting for follow-up treatment of coronary artery disease in a community cardiology practice, comparing atherosclerotic event rates and medication usage in a 2-year treatment period prior to 2002 and a 2-year period in 2005-2008. Care was provided in both the early and later eras by 7 board-certified cardiologists in a suburban cardiology practice. Medication usage was compared in both treatment eras. The primary outcome was a composite event rate of myocardial infarction, cerebrovascular events, and coronary interventions.ResultsThree hundred and fifty-seven patients were studied, with a follow-up duration of 12.1 (±3.5) years. There were 132 composite events in 104 patients (29.1%) in the early era compared to 40 events in 33 patients (9.2%) in the later era (p < 0.0001). From the early to the later eras, there was an increase in use of β-blockers (66% to 83%, p < 0.0001), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (34% to 80%, p < 0.0001), and statins (40% to 90%, p < 0.0001).ConclusionsApplication of aggressive evidence-based medication protocols for treatment of atherosclerosis is associated with a significant decrease in atherosclerotic events or need for coronary intervention.

Risk factor reduction in progression of angiographic coronary artery disease

“…The 3-month criterion was chosen because many pa tients received cardiac catheterization with coronary angiography shortly before starting treatment at our cardiology outpatient practice. Coronary artery disease was diagnosed as previously described [11][12][13][14][15][16][17][18][19].…”

The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice

“…Patients who were treated with statins within the first year of follow-up were excluded from the study in order to achieve comparable duration of follow-up. Out of 1, 599 patients screened at the practice [9], 305 patients met all criteria and were included in the study.…”

Feasibility study for removing calcified material using a planar rectangular ultrasound transducer

“…But sometimes, medication or surgical procedures may be recommended as well [4]. Over the years researchers were involved in clinical research to develop medication treatments and approaches to reduce the risk of heart attack and other medical problems caused by atherosclerosis (for example Angiotensin II receptor blockers (ARBs) [5], Calcium Channel Blockers [5], Cholesterol Medications [6], and Diuretics [7]).…”