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Cardiovascular event rate and death in high-risk secondary prevention patient cohort in Finland: A registry study
Iiro Toppila1, Liisa Ukkola-Vuoti1, Julia Perttilä2
1Medaffcon Oy, Espoo, Finland.
Insights
Patients with atherosclerotic cardiovascular disease face high risks of recurrent events and death, especially within six months of their first event. Prompt secondary prevention is crucial to reduce these risks.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Atherosclerotic cardiovascular disease (CVD) affects numerous patients, placing them at significant risk for life-threatening cardiovascular events.
- Real-world data is essential for understanding the long-term prognosis and management of patients post-cardiovascular event.
Purpose of the Study:
- To evaluate the risk of recurrent cardiovascular events or death in a Finnish population following an initial atherosclerotic cardiovascular event.
- To identify risk factors and assess the time to recurrence after a first cardiovascular event.
Main Methods:
- Retrospective registry study design.
- Inclusion of patients with an incident atherosclerotic CV event between 2012 and 2016.
- Follow-up for recurrent CV events or death, with risk and time-to-recurrence analyses.
Main Results:
- 48,405 patients were followed post-index CV event.
- The event rate was 14.34 events per 100 patient-years.
- At 5 years, 41.5% experienced death or recurrent CV event, with death being the most common (61.5%). Recurrent events and deaths accelerated within 6 months post-index event, often mirroring the initial event type (cardiac or cerebrovascular).
Conclusions:
- High incidence of recurrent CV events and all-cause mortality observed post-first CV event.
- The first 6 months post-index event represent a critical period for increased risk.
- Accelerated event rates after each subsequent CV event underscore the need for immediate and intensified secondary prevention strategies to meet treatment goals.
Background:
A large number of patients are living with atherosclerotic cardiovascular (CV) disease and thus are at risk of life-threatening CV events.
Hypothesis:
This study evaluated the risk for a recurrent CV event or death in Finnish real-world data.
Methods:
Patients with an incident atherosclerotic CV event between 2012 and 2016 were included in this retrospective registry study and followed for recurrent CV events or death. The risk and risk factors of recurrent CV events or death and time from the first CV event to recurrence were assessed.
Results:
A total of 48,405 patients were followed from their first CV event. The event rate was 14.34 events per 100 patient-years. Multistate models suggested that at 5 years post index CV event, 41.5% of the patients had died or suffered a recurrent CV event. Death was the most common type of subsequent event (61.5%). After the first CV event, there were rapid increases both in recurrent CV events and deaths during the next 6 months. The subsequent CV event was usually of the same type as the first, which was of the cardiac or cerebrovascular cluster.
Conclusions:
The incidence of recurrent CV events and all-cause mortality was high in patients suffering from their first CV event, particularly during the first 6 months after the index event. Death was the most common subsequent event. The event rate accelerated after each additional CV event. This suggests that the acute treatment of the index event should be followed by prompt secondary prevention measures to achieve guideline-recommended goals as soon as possible.
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