000 03451nam a22003857a 4500
008 181108s20182018 xxu||||| |||| 00| 0 eng d
022 _a0735-1097
024 _a10.1016/j.jacc.2018.08.2163 [doi]
024 _aS0735-1097(18)38383-9 [pii]
040 _aOvid MEDLINE(R)
099 _a30384885
245 _aHealthy Behavior, Risk Factor Control, and Survival in the COURAGE Trial.
251 _aJournal of the American College of Cardiology. 72(19):2297-2305, 2018 Nov 06.
252 _aJ Am Coll Cardiol. 72(19):2297-2305, 2018 Nov 06.
253 _aJournal of the American College of Cardiology
260 _c2018
260 _fFY2019
265 _sppublish
266 _d2018-11-09
501 _aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
520 _aBACKGROUND: Individual risk factor control improves survival in patients with stable ischemic heart disease (SIHD). It is uncertain if multiple risk factor control further extends survival.
520 _aCONCLUSIONS: The greater the number of risk factors in control, the higher the probability of survival in patients with SIHD. More effective strategies are needed to achieve comprehensive risk factor control, including healthy behaviors. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation [COURAGE]; NCT00007657).
520 _aCopyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
520 _aMETHODS: Of 2,287 participants in the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial, 2,102 (92%) had complete ascertainment of 6 pre-specified risk factors: systolic blood pressure, low-density lipoprotein cholesterol, smoking, physical activity, diet, and body mass index. Participants received interventions to control these risk factors. The outcome measure was mortality.
520 _aOBJECTIVES: This study determined whether a greater number of risk factors at goal predicted improved survival in SIHD patients.
520 _aRESULTS: During a mean follow-up of 6.8 years, 473 (22.5%) subjects died. In univariate analysis, the greater the number of risk factors controlled, the higher the probability of survival (unadjusted log rank: p < 0.001). In multivariate analysis, the strongest predictors at 1 year of improved survival were being a nonsmoker, regular physical activity, having a systolic blood pressure <130 mm Hg, and following the American Heart Association Step 2 diet. Baseline risk factor values and evidence-based medications did not independently predict survival once risk factor control at 1 year was included in the model. Having 4 to 6 risk factors compared with 0 to 1 risk factor at goal predicted lower mortality (hazard ratios for 4 and 6 controlled risk factors: 0.64; 95% confidence interval: 0.41 to 0.98, and 0.27; 95% confidence interval: 0.09 to 0.79, respectively).
546 _aEnglish
650 _aIN PROCESS -- NOT YET INDEXED
651 _aMedStar Heart & Vascular Institute
657 _aJournal Article
700 _aWeintraub, William S
790 _aBerman DS, Boden WE, COURAGE Trial Group, Hartigan PM, Kostuk WJ, Mancini GBJ, Maron DJ, Sedlis SP, Spertus JA, Teo KK, Weintraub WS
856 _uhttps://dx.doi.org/10.1016/j.jacc.2018.08.2163
_zhttps://dx.doi.org/10.1016/j.jacc.2018.08.2163
942 _cART
_dArticle
999 _c3886
_d3886