Investigation of CHD PROGNOSIS: New long-term follow-up data

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Objective — to investigate the long-term prognosis of stable coronary heart disease in the patients included in the CHD PROGNOSIS Register. Subject and methods. The latter included the Moscow Region’s patients admitted to the hospital of the National Research Center for Preventive Medicine with a referral diagnosis of CHD in January 1, 2004 to December 31, 2007. During their hospitalization, 641 patients (510 men and 131 women; the mean age of the men and women was 56.7±0.4 and 59.8±0.8 years, respectively) underwent coronary angiography (CAG). In 2014, the status was established in 592 (92%) patients; the mean follow-up duration was 7.3±2.19 years. For a subanalysis of outcomes, the investigators identified two patient groups: 1) 100 patients were discharged without a diagnosis of CHD; 2) 514 patients had a verified diagnosis of CHD. Results. There was new evidence on the outcomes of a 7-year follow-up in the patient included in the CHD PROGNOSIS Register. After a follow-up of 7.3 years, the overall rate of primary endpoints (PEP) death, fatal and nonfatal cardiovascular events) in the entire patient cohort was 22%; that of secondary endpoints (SEP) was 45%; total death rates were 18%. Cardiovascular events and CHD complications became a cause of death in 66 and 51%, respectively. Other (noncardiovascular) causes of death amounted to 11%. The cause of death was not established in 23% of cases. The patients with verified CHD had higher rates of PEP than those without CHD (24 and 12.5%, respectively (p<0.05) and SEP (50 and 15%, respectively (p=0.001), but did not differ in the risk of all-cause mortality (19 and 13.6%, respectively (p=0.225). Conclusion. With a longer follow-up of up to 7 years, the mortality rates of the patients with chronic CHD increased twofold and accounted for 19%. The rise in mortality rates occurred with cardiovascular and other causes; however, cardiovascular diseases remained the most common cause of death (66%). The incidence of fatal and nonfatal cardiovascular events in the entire cohort increased during 3 years by 36% and, in terms of revascularizations, by 20%. The persons who were discharged without a diagnosis of CHD had a 2-fold lower incidence of fatal and nonfatal cardiovascular events than those with verified CHD, but did not differ in all-cause mortality rates.

Keywords:

coronary heart disease

long-term prognosis

Authors:

Tolpygina S.N.

FGBU "Gosudarstvennyĭ nauchno-issledovatel'skiĭ tsentr profilakticheskoĭ meditsiny" Minzdrava Rossii

Martsevich S.Iu.

GNITs profilakticheskoĭ meditsiny Minzdrava RF, Pervyĭ MGMU im. I.M. Sechenova, Moskva

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