Secondary prevention of coronary artery disease in high-risk diabetic patients
Abstract To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study. The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among...
Gespeichert in:
| Veröffentlicht in: | Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2003-08, Vol.13 (4), p.238-243 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 243 |
|---|---|
| container_issue | 4 |
| container_start_page | 238 |
| container_title | Nutrition, metabolism, and cardiovascular diseases |
| container_volume | 13 |
| creator | Giorda, C. Maggini, M. Alegiani, S. Spila Turco, S. Raschetti, R. |
| description | Abstract
To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study.
The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment. Only 25% of the coronary patients in secondary prevention were receiving lipid-lowering drugs, and 20% were receiving
β-blockers. None of the patients in 54/185 Diabetic Care Units were on stains, and none in 82/185 Units were on
β-blockers. Multivariate analysis showed a positive correlation between the number of treatments and the taking of statins, and a negative correlation with age.
Our data highlight a gap between the therapeutic guidelines and actual treatment, with wide variability in the delivery of secondary prevention across Units. The out-of-pocket cost of medication, daily treatment burden and geographic area can be ruled out as possible explanatory factors. Physicians' prescription attitudes may be a possible reason. |
| doi_str_mv | 10.1016/S0939-4753(03)80017-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71423158</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0939475303800170</els_id><sourcerecordid>71423158</sourcerecordid><originalsourceid>FETCH-LOGICAL-c361t-9d9b9fd4c52308bc902efb028b372ee86caf0718a8d1f25071903502381d04573</originalsourceid><addsrcrecordid>eNqFkMlOwzAQQC0EoqXwCaCcEBwC4zhO4hNCFZtUwaFwthx7Qg1tHOy0En-PuwiOnGY0erM9Qk4pXFGgxfUUBBNpXnJ2AeyyAqBlCntkSLmAlJWZ2CfDX2RAjkL4AGAlsPyQDGhecGC8HJLnKWrXGuW_k87jCtveujZxTaKdd-26rHyPMRgbUAVMbJvM7Pss9TZ8xqKqsbc66VRvY284JgeNmgc82cURebu_ex0_ppOXh6fx7STVrKB9KoyoRWNyzTMGVa0FZNjUkFV1vByxKrRqoKSVqgxtMh5TEc-FjFXUQM5LNiLn27mdd19LDL1c2KBxPlctumWQJc0zRnkVQb4FtXcheGxk5-0i_iUpyLVIuREp15YkMLkRGZMROdstWNYLNH9dO3MRuNkCGN9cWfQy6KhAo7EedS-Ns_-s-AGLKYJm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71423158</pqid></control><display><type>article</type><title>Secondary prevention of coronary artery disease in high-risk diabetic patients</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Giorda, C. ; Maggini, M. ; Alegiani, S. Spila ; Turco, S. ; Raschetti, R.</creator><creatorcontrib>Giorda, C. ; Maggini, M. ; Alegiani, S. Spila ; Turco, S. ; Raschetti, R. ; the DAI Study Group ; Diabetic Care Units Study</creatorcontrib><description>Abstract
To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study.
The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment. Only 25% of the coronary patients in secondary prevention were receiving lipid-lowering drugs, and 20% were receiving
β-blockers. None of the patients in 54/185 Diabetic Care Units were on stains, and none in 82/185 Units were on
β-blockers. Multivariate analysis showed a positive correlation between the number of treatments and the taking of statins, and a negative correlation with age.
Our data highlight a gap between the therapeutic guidelines and actual treatment, with wide variability in the delivery of secondary prevention across Units. The out-of-pocket cost of medication, daily treatment burden and geographic area can be ruled out as possible explanatory factors. Physicians' prescription attitudes may be a possible reason.</description><identifier>ISSN: 0939-4753</identifier><identifier>EISSN: 1590-3729</identifier><identifier>DOI: 10.1016/S0939-4753(03)80017-0</identifier><identifier>PMID: 14650357</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Adult ; Aged ; Cohort Studies ; cohort study ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - etiology ; Coronary Artery Disease - prevention & control ; Diabetes Mellitus, Type 2 ; Female ; Guideline Adherence ; Humans ; Hypolipidemic Agents - therapeutic use ; Incidence ; Italy - epidemiology ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Prevalence ; statins ; Type 2 diabetes mellitus</subject><ispartof>Nutrition, metabolism, and cardiovascular diseases, 2003-08, Vol.13 (4), p.238-243</ispartof><rights>2003 Elsevier Science</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-9d9b9fd4c52308bc902efb028b372ee86caf0718a8d1f25071903502381d04573</citedby><cites>FETCH-LOGICAL-c361t-9d9b9fd4c52308bc902efb028b372ee86caf0718a8d1f25071903502381d04573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0939-4753(03)80017-0$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14650357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giorda, C.</creatorcontrib><creatorcontrib>Maggini, M.</creatorcontrib><creatorcontrib>Alegiani, S. Spila</creatorcontrib><creatorcontrib>Turco, S.</creatorcontrib><creatorcontrib>Raschetti, R.</creatorcontrib><creatorcontrib>the DAI Study Group</creatorcontrib><creatorcontrib>Diabetic Care Units Study</creatorcontrib><title>Secondary prevention of coronary artery disease in high-risk diabetic patients</title><title>Nutrition, metabolism, and cardiovascular diseases</title><addtitle>Nutr Metab Cardiovasc Dis</addtitle><description>Abstract
To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study.
The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment. Only 25% of the coronary patients in secondary prevention were receiving lipid-lowering drugs, and 20% were receiving
β-blockers. None of the patients in 54/185 Diabetic Care Units were on stains, and none in 82/185 Units were on
β-blockers. Multivariate analysis showed a positive correlation between the number of treatments and the taking of statins, and a negative correlation with age.
Our data highlight a gap between the therapeutic guidelines and actual treatment, with wide variability in the delivery of secondary prevention across Units. The out-of-pocket cost of medication, daily treatment burden and geographic area can be ruled out as possible explanatory factors. Physicians' prescription attitudes may be a possible reason.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Cohort Studies</subject><subject>cohort study</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - etiology</subject><subject>Coronary Artery Disease - prevention & control</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Female</subject><subject>Guideline Adherence</subject><subject>Humans</subject><subject>Hypolipidemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care)</subject><subject>Practice Guidelines as Topic</subject><subject>Prevalence</subject><subject>statins</subject><subject>Type 2 diabetes mellitus</subject><issn>0939-4753</issn><issn>1590-3729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMlOwzAQQC0EoqXwCaCcEBwC4zhO4hNCFZtUwaFwthx7Qg1tHOy0En-PuwiOnGY0erM9Qk4pXFGgxfUUBBNpXnJ2AeyyAqBlCntkSLmAlJWZ2CfDX2RAjkL4AGAlsPyQDGhecGC8HJLnKWrXGuW_k87jCtveujZxTaKdd-26rHyPMRgbUAVMbJvM7Pss9TZ8xqKqsbc66VRvY284JgeNmgc82cURebu_ex0_ppOXh6fx7STVrKB9KoyoRWNyzTMGVa0FZNjUkFV1vByxKrRqoKSVqgxtMh5TEc-FjFXUQM5LNiLn27mdd19LDL1c2KBxPlctumWQJc0zRnkVQb4FtXcheGxk5-0i_iUpyLVIuREp15YkMLkRGZMROdstWNYLNH9dO3MRuNkCGN9cWfQy6KhAo7EedS-Ns_-s-AGLKYJm</recordid><startdate>20030801</startdate><enddate>20030801</enddate><creator>Giorda, C.</creator><creator>Maggini, M.</creator><creator>Alegiani, S. Spila</creator><creator>Turco, S.</creator><creator>Raschetti, R.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030801</creationdate><title>Secondary prevention of coronary artery disease in high-risk diabetic patients</title><author>Giorda, C. ; Maggini, M. ; Alegiani, S. Spila ; Turco, S. ; Raschetti, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-9d9b9fd4c52308bc902efb028b372ee86caf0718a8d1f25071903502381d04573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Adult</topic><topic>Aged</topic><topic>Cohort Studies</topic><topic>cohort study</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - etiology</topic><topic>Coronary Artery Disease - prevention & control</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Female</topic><topic>Guideline Adherence</topic><topic>Humans</topic><topic>Hypolipidemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcome Assessment (Health Care)</topic><topic>Practice Guidelines as Topic</topic><topic>Prevalence</topic><topic>statins</topic><topic>Type 2 diabetes mellitus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giorda, C.</creatorcontrib><creatorcontrib>Maggini, M.</creatorcontrib><creatorcontrib>Alegiani, S. Spila</creatorcontrib><creatorcontrib>Turco, S.</creatorcontrib><creatorcontrib>Raschetti, R.</creatorcontrib><creatorcontrib>the DAI Study Group</creatorcontrib><creatorcontrib>Diabetic Care Units Study</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giorda, C.</au><au>Maggini, M.</au><au>Alegiani, S. Spila</au><au>Turco, S.</au><au>Raschetti, R.</au><aucorp>the DAI Study Group</aucorp><aucorp>Diabetic Care Units Study</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Secondary prevention of coronary artery disease in high-risk diabetic patients</atitle><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle><addtitle>Nutr Metab Cardiovasc Dis</addtitle><date>2003-08-01</date><risdate>2003</risdate><volume>13</volume><issue>4</issue><spage>238</spage><epage>243</epage><pages>238-243</pages><issn>0939-4753</issn><eissn>1590-3729</eissn><abstract>Abstract
To compare guideline implementation and the actual delivery of secondary prevention for coronary artery disease in the cohort of Italian diabetic patients enrolled in the DAI study.
The DAI study is a multicentre cohort study of the prevalence and incidence of macroangiopathic events among 19,570 type 2 diabetic patients attending 201 Diabetic Care Units. For this study, we selected 1,475 subjects with a history of myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty at enrollment. Only 25% of the coronary patients in secondary prevention were receiving lipid-lowering drugs, and 20% were receiving
β-blockers. None of the patients in 54/185 Diabetic Care Units were on stains, and none in 82/185 Units were on
β-blockers. Multivariate analysis showed a positive correlation between the number of treatments and the taking of statins, and a negative correlation with age.
Our data highlight a gap between the therapeutic guidelines and actual treatment, with wide variability in the delivery of secondary prevention across Units. The out-of-pocket cost of medication, daily treatment burden and geographic area can be ruled out as possible explanatory factors. Physicians' prescription attitudes may be a possible reason.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>14650357</pmid><doi>10.1016/S0939-4753(03)80017-0</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0939-4753 |
| ispartof | Nutrition, metabolism, and cardiovascular diseases, 2003-08, Vol.13 (4), p.238-243 |
| issn | 0939-4753 1590-3729 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71423158 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adrenergic beta-Antagonists - therapeutic use Adult Aged Cohort Studies cohort study Coronary Artery Disease - epidemiology Coronary Artery Disease - etiology Coronary Artery Disease - prevention & control Diabetes Mellitus, Type 2 Female Guideline Adherence Humans Hypolipidemic Agents - therapeutic use Incidence Italy - epidemiology Male Middle Aged Outcome Assessment (Health Care) Practice Guidelines as Topic Prevalence statins Type 2 diabetes mellitus |
| title | Secondary prevention of coronary artery disease in high-risk diabetic patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T21%3A25%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Secondary%20prevention%20of%20coronary%20artery%20disease%20in%20high-risk%20diabetic%20patients&rft.jtitle=Nutrition,%20metabolism,%20and%20cardiovascular%20diseases&rft.au=Giorda,%20C.&rft.aucorp=the%20DAI%20Study%20Group&rft.date=2003-08-01&rft.volume=13&rft.issue=4&rft.spage=238&rft.epage=243&rft.pages=238-243&rft.issn=0939-4753&rft.eissn=1590-3729&rft_id=info:doi/10.1016/S0939-4753(03)80017-0&rft_dat=%3Cproquest_cross%3E71423158%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71423158&rft_id=info:pmid/14650357&rft_els_id=S0939475303800170&rfr_iscdi=true |