PURPOSE: This study is aimed at investigating gender differences in the medical management of patients with coronary heart disease (CHD). METHODS: Analyses were based on the ESC EORP EUROASPIRE V (European Survey Of Cardiovascular Disease Prevention And Diabetes) survey. Consecutive patients between 18 and 80 years, hospitalized for a coronary event, were included in the study. Information on cardiovascular medication intake at hospital discharge and at follow-up (≥ 6 months to < 2 years after hospitalization) was collected. RESULTS: Data was available for 8261 patients (25.8% women). Overall, no gender differences were observed in the prescription and use of cardioprotective medication like aspirin, beta-blockers, and ACE-I/ARBs (P > 0.01) at discharge and follow-up respectively. However, a statistically significant difference was found in the use of statins at follow-up, in disfavor of women (82.8% vs. 77.7%; P < 0.001). In contrast, at follow-up, women were more likely to use diuretics (31.5% vs. 39.5%; P < 0.001) and calcium channel blockers (21.2% vs. 28.8%; P < 0.001), whereas men were more likely to use anticoagulants (8.8% vs. 7.0%; P < 0.001). Overall, no gender differences were found in total daily dose intake (P > 0.01). Furthermore, women were less likely than men to have received a CABG (20.4% vs. 13.2%; P < 0.001) or PCI (82.1% vs. 74.9%; P < 0.001) at follow-up. No gender differences were observed in prescribed (P = 0.10) and attended (P = 0.63) cardiac rehabilitation programs. CONCLUSION: The EUROASPIRE V results show only limited gender differences in the medical management of CHD patients. Current findings suggest growing awareness about risk in female CHD patients.

• MeSH
• hospitalizace statistika a číselné údaje   MeSH
• kardiovaskulární látky * klasifikace   terapeutické užití   MeSH
• kardiovaskulární rehabilitace statistika a číselné údaje   MeSH
• koronární bypass statistika a číselné údaje   MeSH
• koronární nemoc * farmakoterapie   epidemiologie   prevence a kontrola   MeSH
• lékařská praxe - způsoby provádění MeSH
• lidé středního věku MeSH
• lidé MeSH
• management péče o pacienta metody   statistika a číselné údaje   MeSH
• sekundární prevence metody   MeSH
• sexuální faktory MeSH
• zdraví - znalosti, postoje, praxe MeSH
• zdraví žen MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

The EUROASPIRE surveys (EUROpean Action on Secondary Prevention through Intervention to Reduce Events) demonstrated that most European coronary patients fail to achieve lifestyle, risk factor and therapeutic targets. Here we report on the 2-year incidence of hard cardiovascular (CV) endpoints in the EUROASPIRE IV cohort. EUROASPIRE IV (2012-2013) was a large cross-sectional study undertaken at 78 centres from selected geographical areas in 24 European countries. Patients were interviewed and examined at least 6 months following hospitalization for a coronary event or procedure. Fatal and non-fatal CV events occurring at least 1 year after this baseline screening were registered. The primary outcome in our analyses was the incidence of CV death or non-fatal myocardial infarction, stroke or heart failure. Cox regression models, stratified for country, were fitted to relate baseline characteristics to outcome. Our analyses included 7471 predominantly male patients. Overall, 222 deaths were registered of whom 58% were cardiovascular. The incidence of the primary outcome was 42 per 1000 person-years. Comorbidities were strongly and significantly associated with the primary outcome (multivariately adjusted hazard ratio HR, 95% confidence interval): severe chronic kidney disease (HR 2.36, 1.44-3.85), uncontrolled diabetes (HR 1.89, 1.50-2.38), resting heart rate ≥ 75 bpm (HR 1.74, 1.30-2.32), history of stroke (HR 1.70, 1.27-2.29), peripheral artery disease (HR 1.48, 1.09-2.01), history of heart failure (HR 1.47, 1.08-2.01) and history of acute myocardial infarction (HR 1.27, 1.05-1.53). Low education and feelings of depression were significantly associated with increased risk. Lifestyle factors such as persistent smoking, insufficient physical activity and central obesity were not significantly related to adverse outcome. Blood pressure and LDL-C levels appeared to be unrelated to cardiovascular events irrespective of treatment. In patients with stabilized CHD, comorbid conditions that may reflect the ubiquitous nature of atherosclerosis, dominate lifestyle-related and other modifiable risk factors in terms of prognosis, at least over a 2-year follow-up period.

• MeSH
• incidence MeSH
• kardiovaskulární nemoci epidemiologie   MeSH
• koronární nemoc terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• životní styl MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Hypertension is the most prevalent major independent risk factor for developing coronary heart disease (CHD). The present analysis aimed to assess blood pressure (BP) distribution and factors associated with insufficient BP control in coronary patients from 24 countries participating in the European Society of Cardiology (ESC) EURoObservational Research Programme (EORP) EUROASPIRE IV survey. METHODS: EUROASPIRE IV is a cross-sectional study conducted in 2012-2013 in patients aged 80 years or less hospitalized for CHD with a follow-up visit at a median of 16 months later. Logistic regression analysis was applied to confirm factors associated with BP control defined as less than 140/90 mmHg for nondiabetic patients and less than 140/85 mmHg for diabetic patients. RESULTS: A total of 7998 patients (response rate, 48.7%) attended the follow-up visit. Complete data were available in 7653 participants (mean age 62.5 ± 9.6 years). The BP goal was achieved in 57.6%. Patients failing to achieve the BP goal were older, had higher BMI, had more often a history of coronary artery bypass grafting (CABG) and reported diabetes more frequently. Logistic regression confirmed the following independent significant predictors of not achieving the BP goal: a history of diabetes [odds ratio (OR) 1.75], obesity (OR 1.70 vs. normal BMI), overweight (OR 1.28 vs. normal BMI), age at least 65 years (OR 1.53) and CABG as the index event (OR 1.26 vs. acute MI). CONCLUSION: EUROASPIRE IV found insufficient BP control in a large proportion of patients with stable CHD, with diabetes, increased BMI, older age and CABG as the index event being independent predictors of poor BP control.

• MeSH
• hypertenze patofyziologie   MeSH
• kardiovaskulární nemoci patofyziologie   MeSH
• koronární nemoc patofyziologie   MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• registrace MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in 2016-2018. The main objective was to determine whether the 2016 Joint European Societies' guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice. METHODS: The method used was a cross-stional survey in 78 centres from 16 European countries. Patients without a history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering treatments were identified and interviewed ≥ 6 months after the start of medication. RESULTS: A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 ± 11.6 years) interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5% obese (body mass index ≥30 kg/m2) and 63.8% centrally obese (waist circumference ≥88 cm for women, ≥102 cm for men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%. CONCLUSION: The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus, the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology programmes is substantial.

• MeSH
• diabetes mellitus 2. typu * MeSH
• kardiologie * MeSH
• kardiovaskulární nemoci * diagnóza   epidemiologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• primární prevence MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

AIMS: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. DESIGN: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. METHODS: Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. RESULTS: A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. CONCLUSION: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.

• MeSH
• adherence pacienta MeSH
• chování snižující riziko * MeSH
• dieta škodlivé účinky   MeSH
• hodnocení rizik MeSH
• kardiovaskulární látky terapeutické užití   MeSH
• kardiovaskulární nemoci diagnóza   epidemiologie   patofyziologie   prevence a kontrola   MeSH
• kouření škodlivé účinky   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ochranné faktory MeSH
• průřezové studie MeSH
• průzkumy zdravotní péče MeSH
• registrace MeSH
• rizikové faktory MeSH
• sedavý životní styl MeSH
• sekundární prevence MeSH
• senioři MeSH
• statiny terapeutické užití   MeSH
• výsledek terapie MeSH
• zdravotní stav MeSH
• zdravý životní styl * MeSH
• životní styl * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Úvod: Sekundární kardiovaskulární (KV) prevence po prodělaném infarktu myokardu (IM) je neméně důležitá než léčba akutního IM. Lepší KV prevence může rozhodující měrou přispět k pokračování pozitivních trendů KV morbidity a mortality v České republice v posledních třech desetiletích. Cíl: Stanovit, jak jsou do praxe implementována nedávná evropská doporučení pro sekundární prevenci ischemické choroby srdeční (ICHS) (2012). Metodika: Konsekutivně a retrospektivně bylo vybráno 624 pacientů, mužů a žen ve věku ≤ 80 let, hospitalizovaných pro akutní koronární syndrom a/nebo chirurgickou či katetrizační koronární revaskularizaci. Byl proveden rozbor chorobopisů a následně byli ambulantně vyšetřeni respondenti, minimálně šest měsíců, maximálně dva roky po přijetí k hospitalizaci. Výsledky: Celkem bylo vyšetřeno 406 respondentů. Z nich 20 % byli aktivní kuřáci, 44,8 % bylo obézních (BMI ≥ 30), v pásmu nadváhy a obezity (BMI ≥ 25) bylo 85,5 % respondentů, centrálně obézních (obvod pasu ≥ 102 cm u mužů, ≥ 88 cm u žen) 70,2 %, doporučované fyzické aktivity (30 minut 5× týdně) nedosáhlo 85 %. Krevní tlak zvýšený nad hodnoty požadované v doporučeních kardiovaskulární prevence z roku 2012 (≥ 140/90 mm Hg, u diabetiků ≥ 140/80 mm Hg) mělo 55,1 % pacientů, zvýšený LDL-cholesterol (≥ 1,8 mmol/l) 63,5 % pacientů. Diabetes (známý a nově diagnostikovaný) vykazovalo 41,2 % respondentů, prediabetes 23,4 %. Při použití glukózového tolerančního testu to bylo 44,7 %, respektive 32,3 %. V době našeho vyšetření bylo 88,4 % pacientů léčeno antiagregancii, 81,3 % beta-blokátorem, 78,8 % inhibitory angiotenzin konvertujícího enzymu (ACEI) nebo antagonistou receptoru ATII, 92,1 % statinem, 92,9 % prodělalo koronární revaskularizaci. Závěr: Většina pacientů v sekundární prevenci ICHS má nezdravý životní styl - nezdravou dietu a nedostatečnou pohybovou aktivitu. Prevalence nadváhy, obezity a diabetu je velmi vysoká, prevalence obezity a centrální obezity se dále zvýšila. Farmakoterapie je v sekundární prevenci používána u většiny pacientů, ale doporučených hodnot krevního tlaku, lipidového a glycidového metabolismu je dosahováno jen u menšiny.

Introduction: Secondary prevention after myocardial infarction is at least as important as treatment of the acute phase. Improved cardiovascular (CV) prevention can decisively contribute to the continuation of posi-tive trends of CV morbidity and mortality seen in the Czech Republic in last three decades.Objectives: To determine, in patients with coronary heart disease (CHD), how the treatment goals as defi ned by the current European guidelines on CV secondary prevention (2012) are implemented in clinical practice.Methods: Patients ≤ 80 years when hospitalized for acute coronary syndrome, and/or CABG or PCI were iden-tifi ed from hospital records and invited to outpatient clinical investigation (interview) not less than 6 months and not more than 2 years after hospital discharge. Data collection was performed based on a review of medical records and the interview.Results: Of 624 invited patients, 406 responders were interviewed. Among these, 20% were smokers, 44.8% were obese (BMI ≥ 30), 85.5% were overweight or obese (BMI ≥ 25), 70.2% had central obesity (waist cir-cumference ≥ 102 cm in men, ≥ 88 cm in women), the recommended level of physical activity (30 minutes 5 times a week) was not attained by 85%. Raised blood pressure (≥ 140/90 mmHg, in diabetics ≥ 140/80 mmHg) was measured in 55.1%, elevated LDL-cholesterol (≥ 1.8 mmol/L) in 63.5% of responders. Manifest diabetes mellitus (known plus newly discovered at interview) was present in 41.2%, and prediabetes in 23.4% of pa-tients. The respective fi gures when using the oral glucose tolerance test (OGTT) were 44.7% and 32.3%. At interview, 88.4% of patients were being treated with aspirin or other antiplatelet drugs, 81.3% with beta--blockers, 78.8% with ACE inhibitors or angiotensin receptor blockers (ARBs), 92.1% with statins, and 92.9% had undergone revascularization.Conclusion: The majority of coronary patients have unhealthy lifestyles such as unhealthy diet and sedentary behavior. The prevalence of overweight, obesity, and diabetes is very high, and prevalence of obesity further increased. Although pharmacotherapy is used in the majority of patients, the recommended levels of blood pressure, lipid, and glucose metabolism are achieved in only a minority.

BACKGROUND: In 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. METHODS: A 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. RESULTS: A 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. CONCLUSIONS: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.

• MeSH
• antagonisté receptorů pro angiotenzin terapeutické užití   MeSH
• antihypertenziva terapeutické užití   MeSH
• beta blokátory terapeutické užití   MeSH
• diabetes mellitus 2. typu komplikace   farmakoterapie   MeSH
• dodržování směrnic * MeSH
• dyslipidemie komplikace   farmakoterapie   metabolismus   MeSH
• hypertenze komplikace   farmakoterapie   MeSH
• hypoglykemika terapeutické užití   MeSH
• inhibitory ACE terapeutické užití   MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• kardiotonika terapeutické užití   MeSH
• krevní tlak MeSH
• LDL-cholesterol metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci koronárních tepen komplikace   farmakoterapie   MeSH
• průřezové studie MeSH
• registrace * MeSH
• rizikové faktory MeSH
• sekundární prevence MeSH
• senioři MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• statiny terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVE: The aim of this study was to investigate gender related differences in the management and risk factor control of patients with coronary heart disease (CHD), taking into account their age and educational level. METHODS: Analyses are based on the EUROASPIRE IV (EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events) survey. Males and females between 18 and 80years of age, hospitalized for a first or recurrent coronary event were included in the study. RESULTS: Data were available for 7998 patients of which 75.6% were males. Overall, females had a worse risk factor profile compared to males and were more likely to have 3 or more risk factors (29.5% vs. 34.9%; p<0.001) across all age groups. A significant gender by education interaction (p<0.05) and gender by age interaction effect (p<0.05) was found. Furthermore, males were more likely to have a LDL-cholesterol on target (OR=1.50[1.28-1.76]), a HbA1c on target (OR=1.33[1.07-1.64]), to be non-obese (OR=1.45[1.30-1.62]) and perform adequate physical activity (OR=1.71[1.46-2.00]). In contrast males were less likely to be non-smokers (OR=0.71[0.60-0.83]). Furthermore, males were less likely to have made a dietary change (OR=0.78[0.64-0.95]) or a smoking cessation attempt (OR=0.70[0.50-0.96]) and more likely to have received smoking cessation advice if they were smokers (OR=1.52[1.10-2.09]). CONCLUSION: Whereas gender differences in CHD treatment are limited, substantial differences were found regarding target achievement. The largest gender difference was seen in less educated and elderly patients. The gender gap declined with decreasing age and higher education.

• MeSH
• kardiologie metody   MeSH
• kardiovaskulární nemoci diagnóza   epidemiologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• primární prevence metody   MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• sekundární prevence metody   MeSH
• senioři MeSH
• sexuální faktory MeSH
• společnosti lékařské * MeSH
• stupeň vzdělání * MeSH
• věkové faktory MeSH
• zdravotnické přehledy metody   MeSH
• životní styl MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

BACKGROUND: The purpose of this study was to ascertain way in which conventional risk factors, readiness to modify behaviour and to comply with recommended medication, and the effect of this medication were associated with education in patients with established coronary heart disease (CHD). METHODS: The EUROASPIRE IV (EUROpean Action on Secondary Prevention by Intervention to Reduce Events) study was a cross-sectional survey undertaken in 24 European countries to ascertain how recommendations on secondary CHD prevention are being followed in clinical practice. Consecutive patients, men and women ≤80 years of age who had been hospitalized for an acute coronary syndrome or revascularization procedure, were identified retrospectively. Data were collected through an interview with examinations at least six months and no later than three years after hospitalization. RESULTS: A total of 7937 patients (1934 (24.37%) women) were evaluated. Patients with primary education were older, with a larger proportion of women. Control of risk factors, as defined by Joint European Societies 4 and 5 guidelines, was significantly better with higher education for current smoking (p = 0.001), overweight and obesity (p = 0.047 and p = 0.029, respectively), low physical activity (p < 0.001) and low high-density lipoprotein (HDL)-cholesterol (p = 0.011) in men, and for obesity (p = 0.005), high blood pressure (p < 0.005 and p < 0.001), low physical activity (p = 0.001), diabetes (p < 0.001) and low HDL-cholesterol (p = 0.023) in women. Patients with primary and secondary education were more often treated with diuretics and antidiabetic drugs. Better control of hypertension was achieved in patients with higher education. CONCLUSION: Particular risk communication and control are needed in secondary CHD prevention for patients with lower educational status.

• MeSH
• koronární nemoc * MeSH
• rizikové faktory * MeSH
• sekundární prevence * MeSH
• vzdělávání pacientů jako téma * MeSH

Je uvedena evropská definice markeru, resp. biomarkeru. Jedná se o faktor, který je měřitelný a je indikátorem fyziologického nebo i patologického biologického procesu v lidském organizmu. Jsou zmíněné i přenesené významy tohoto pojmu v jiných oblastech medicíny. Je vysvětlen význam, kategorizace i určování celkového kardiovaskulárního (KV) rizika podle tabulek rizika SCORE u pacientů v primární prevenci KV onemocnění. Reziduální (kardio)vaskulární riziko existuje u pacientů v primární nebo sekundární prevenci KV nemocí, kteří jsou léčeni podle současných doporučených postupů a dosahují cílových hodnot cholesterolu resp. LDL-cholesterolu, krevního tlaku, případně i glykemie. Toto reziduální riziko je dané především non-LDL dyslipidemií, tzv. aterogenní dyslipidemií (definice mezinárodní iniciativy R3i). Investigátoři evropských preventivních studií EUROASPIRE zjistili 5letou KV mortalitu u nemocných zařazených do prvních 2 studií, která byla ve významné pozitivní asociaci a glykemií, kouřením a hladinou celkového cholesterolu. V naší nedávné práci jsme zjistili, že u českých nemocných se stabilní ICHS zařazených do studií EUROASPIRE v posledních 16 letech narůstá strmě BMI a výskyt DM2T. Vybrali jsme několik markerů pro stanovení reziduálního rizika: aterogenní dyslipidemii, aterogenní index plazmy podle Dobiášové a hypertriglyceridemický pas (surogát inzulinové rezistence a kardiometabolického syndromu). Z našich analýz je patrno, že přestože stoupala v průběhu sledování těchto pacientů indikace statinů, ACE inhibitorů, antiagregancií a antikoagulancií, markery reziduálního KV rizika zůstaly v podstatě nezměněné a významně častěji se vyskytovaly u nemocných s diabetem.

The European definition of biomarker is presented; it is a measurable factor, which reflects a physiological or pathological process in human body. There are also mentioned transferred meanings of the term marker used in different fields of medicine. The importance, categorization and calculation of global cardiovascular (CV) risk are explained in patients in primary prevention of CV disease (SCORE risk chart). Residual CV risk persists in patients in primary or secondary prevention of CV diseases treated according to current guidelines, even if their risk factors (blood pressure, LDL-cholesterol, glucose level) have achieved the recommended values. This residual risk was done by non-LDL dyslipidemia especially, so called atherogenic dyslipidemia (Residual Risk Reduction Initiative definition). Investigators of preventive EUROASPIRE studies assessed, that 5-year mortality from CV diseases was in a positive association with glucose level, smoking and total cholesterol. In our recent analysis, we have described among the Czech samples of EUROASPIRE studies I-IV, that BMI and prevalence of diabetes increase during the last 16 years very steeply. Patients with stable coronary heart diseases in combination with diabetes have had higher prevalence of residual risk markers (atherogenic dyslipidemia, atherogenic index of plasma described by M. Dobiasova and hypertriglyceridemic waist) than patients without diabetes. Except of prescription of statins, ACE inhibitors, antiaggregative or anticoagulative drugs was increasing, the residual CV risk was not changing during the followed period of 16 years.

• MeSH
• biologické markery * MeSH
• cholesterol fyziologie   MeSH
• kardiovaskulární nemoci * diagnóza   prevence a kontrola   MeSH
• lidé MeSH
• riziko MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH