Introduction: myocardial infarction (MI), peripheral vascular disease and isch aemic cerebral vascular accident (CVA) are three manifestations of the same dise ase, atherothrombosis, and they share the same pathophysi...Introduction: myocardial infarction (MI), peripheral vascular disease and isch aemic cerebral vascular accident (CVA) are three manifestations of the same dise ase, atherothrombosis, and they share the same pathophysiology and prognosis. Ob jective: the aim of this work was to describe the clinical characteristics and t he medical management of polyvascular patients in cardiology. Method: cardiologi sts from all over the country participated in a consultation register for 3 week s. The clinical characteristics and medical management for the first 3 patients on the register for each cardiologist were studied in a national multicentre stu dy and then compared according to whether the atherothrombotic disease was isola ted or polyvascular. Results: in total, 100 429 patients were examined during th e period of the register and 2 780 were included in the study. Polyvascular pati ents represented 7%of the register and 22%of the vascular patients. These pati ents with multiple manifestations were frequently diabetics. A lipid profile was available less often in the cardiac patients when they had another disorder (72 .4%) than in the case of an isolated disorder (78.9%). Whatever the initial di sorder, dyslipidaemia was less often controlled in the case of polyvascular dise ase (63%of LDL C ≥.3g/l in polyvascular cardiac patients vs 52%in cardiac pa tients with isolated disease). In cardiac patients, the presence of peripheral v ascular disease was associated with less prescription of beta blockers (OR=0.4 [ 0.3-0.6]), the presence of CVA was associated with less prescription of statin s (OR=0.7[0.5-0.9] ). Eight out of 10 polyvascular patients received anti pla te let aggregation treatment. The presence of multiple atherothrombotic manifestati ons was associated with greater prescription of ACEI, except in cardiac patients . Conclusion: these results improve our understanding of the specific management of polyvascular patients, for whom secondary prevention is paramount due to the higher risk of recurrence. They should prompt the reinforcement of measures whi ch have been shown to be effective, such as managing major risk factors, and in particular the dislipidaemias.展开更多
文摘Introduction: myocardial infarction (MI), peripheral vascular disease and isch aemic cerebral vascular accident (CVA) are three manifestations of the same dise ase, atherothrombosis, and they share the same pathophysiology and prognosis. Ob jective: the aim of this work was to describe the clinical characteristics and t he medical management of polyvascular patients in cardiology. Method: cardiologi sts from all over the country participated in a consultation register for 3 week s. The clinical characteristics and medical management for the first 3 patients on the register for each cardiologist were studied in a national multicentre stu dy and then compared according to whether the atherothrombotic disease was isola ted or polyvascular. Results: in total, 100 429 patients were examined during th e period of the register and 2 780 were included in the study. Polyvascular pati ents represented 7%of the register and 22%of the vascular patients. These pati ents with multiple manifestations were frequently diabetics. A lipid profile was available less often in the cardiac patients when they had another disorder (72 .4%) than in the case of an isolated disorder (78.9%). Whatever the initial di sorder, dyslipidaemia was less often controlled in the case of polyvascular dise ase (63%of LDL C ≥.3g/l in polyvascular cardiac patients vs 52%in cardiac pa tients with isolated disease). In cardiac patients, the presence of peripheral v ascular disease was associated with less prescription of beta blockers (OR=0.4 [ 0.3-0.6]), the presence of CVA was associated with less prescription of statin s (OR=0.7[0.5-0.9] ). Eight out of 10 polyvascular patients received anti pla te let aggregation treatment. The presence of multiple atherothrombotic manifestati ons was associated with greater prescription of ACEI, except in cardiac patients . Conclusion: these results improve our understanding of the specific management of polyvascular patients, for whom secondary prevention is paramount due to the higher risk of recurrence. They should prompt the reinforcement of measures whi ch have been shown to be effective, such as managing major risk factors, and in particular the dislipidaemias.
