Cardiovascular outcome in patients with high risk cardiovascular events in Nakornping Hospital

Objectives Patients with atherosclerosis are at different levels of elevated risk of ischemic events depending on the specific manifestation of the disease and may have varying degrees of future risk for ischemic events. This study evaluated the incidence of composite cardiovascular outcomes of patients with high risk cardiovascular events in Nakornping Hospital. Methods This prospective observational non-interventional cohort study enrolled patients age 45 years or more who met the inclusion criteria of the Outpatient Department of Medicine, Nakornping Hospital, between January 2008 and December 2009. The follow-up period for each patient was 60 months. The composite cardiovascular outcome of cardiovascular deaths, non-fatal myocardial infarctions, non-fatal strokes and hospitalizations for heart failure was determined. Results Of the 387 patients in the Outpatient Department of Medicine of Nakornping Hospital, 103 were in the established atherosclerotic disease group and 284 were in the multiple risk factors group. The rate of overall composite cardiovascular events (cardiovascular death, non-fatal MI, non-fatal stroke, and hospitalization for heart failure) was 3.83%. The rate was higher in the established atherosclerotic disease group than in the multiple risk factors group 6.79% vs. 1.41% (HR = 14.28; 95% CI, 2.26-90.02, p = 0.005) which was driven by hospitalization for heart failure, but the established atherosclerotic disease group had a lower rate of medical treatment for diabetes than the multiple risk factors group. The rate of receipt of anti-diabetic drugs was statistically significantly lower in the established atherosclerotic disease group than in the multiple risk factors group. Conclusions Patients with established atherosclerotic disease have a higher rate of composite cardiovascular outcomes than patients with multiple risk factors, but they have a lower rate of medical treatment for diabetes.