Article

Background Stable coronary artery disease (CAD) is a leading cause of mortality
worldwide. Few studies document the complete sequence of investigation of the
overall stable CAD population during outpatient visits or hospitalisation. Aim To
obtain accurate and up-to-date information on current management of patients with
stable CAD. Methods START (STable coronary Artery diseases RegisTry) was a
prospective, observational, nationwide study aimed at evaluating the
presentation, management, treatment and quality of life of stable CAD patients
presenting to cardiologists during outpatient visits or discharged from
cardiology wards. Results Over a 3-month period, 5070 consecutive patients were
enrolled in 183 participating centres: 72% managed by a cardiologist during
outpatient or day hospital visits and 28% discharged from cardiology wards. The
vast majority of patients (87%) received a coronary angiography (86% of patients
managed during outpatient visits and 90% during hospitalisation; p < 0.0001).
Outpatients more frequently received optimal medical therapy (OMT; i.e. aspirin
or thienopyridine, beta-blockers and statins) compared to hospitalised patients
(70.2% vs 67.1%; p = 0.03). A personalised diet was prescribed in 58% (60.5% in
outpatients and 52.9% in those admitted to hospitals; p < 0.0001), physical
activity programmes were suggested in 65% (69.4% and 54.3%; p < 0.0001) and
smoking cessation was recommended in 71% of currently smoking patients (73.2% and
65.2%; p = 0.02). Conclusions In this large, contemporary registry, patients with
stable CAD discharged from cardiology wards more commonly underwent diagnostic
imaging procedures and less frequently received OMT or lifestyle modification
programmes compared to patients manged by cardiologists during outpatient visits.

Langue : ANGLAIS