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Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic

Citation

Black, JA and Campbell, JA and Parker, SC and Sharman, JE and Nelson, MR and Otahal, P and Hamilton, G and Marwick, TH, Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic, Medical Journal of Australia ISSN 0025-729X (2021) [Refereed Article]


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DOI: doi:10.5694/mja2.50960

Abstract

Objectives: To assess the efficacy of a pro-active, absolute cardiovascular risk-guided approach to opportunistically modifying cardiovascular risk factors in patients without coronary ischaemia attending a chest pain clinic.

Design: Prospective, randomised, open label, blinded endpoint study.

Setting: The rapid access chest pain clinic of Royal Hobart Hospital, a tertiary hospital.

Participants: Patients who presented to the chest pain clinic between 1 July 2014 and 31 December 2017 who had intermediate to high absolute cardiovascular risk scores (5-year risk ≥ 8%). Patients with known cardiac disease or from groups with clinically determined high risk of cardiovascular disease were excluded.

Main outcome measures: The primary endpoint was change in 5-year absolute risk score (Australian absolute risk calculator) at follow-up (at least 12 months after baseline assessment). Secondary endpoints were changes in lipid profile, blood pressure, smoking status, and body mass index, and major adverse cardiovascular events.

Results: The mean change in risk at follow-up was +0.4 percentage points (95% CI, -0.8 to 1.5 percentage points) for the 98 control group patients and -2.4 percentage points (95% CI, -1.5 to -3.4 percentage points) for the 91 intervention group patients; the between-group difference in change was 2.7 percentage points (95% CI, 1.2-4.1 percentage points). Mean changes in lipid profile, systolic blood pressure, and smoking status were larger for the intervention group, but not statistically different from those for the control group.

Conclusions: An absolute cardiovascular risk-guided, pro-active risk factor management strategy employed opportunistically in a chest pain clinic significantly improved 5-year absolute cardiovascular risk scores.

Item Details

Item Type:Refereed Article
Keywords:cardiology, rapid access chest pain clinic, quality of life
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Campbell, JA (Dr Julie Campbell)
UTAS Author:Sharman, JE (Professor James Sharman)
UTAS Author:Nelson, MR (Professor Mark Nelson)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:143375
Year Published:2021
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-03-14
Last Modified:2021-03-15
Downloads:0

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