A comparison of the management and five-year outcomes of patients treated for chronic coronary syndrome between 2006–2007 and 2015–2016 — insights from the PRESAGE registry

Abstract

Background: Changes in the management of patients with chronic coronary syndromes (CCS) require continuous monitoring of results of treatment in daily clinical practice.

The present study contains a comparison of the clinical characteristics, management, and in-hospital and five-year outcomes of patients with CCS enrolled on the Prospective REgistry of Stable AnGina management and trEatment (PRESAGE).

Methods: A group of 3475 patients with CCS were selected who underwent coronary angiography and were divided into two groups who were treated in the years 2006–2007 (1300 [37.4%]) – group I, and during 2015–2016 (2175 [62.6%] – group II). The composite endpoints involved death, non-fatal myocardial infarction (MI), and acute coronary syndrome-driven revascularization.

Results: Comparing patients from group I  to those from group II, group I were younger; 61.8 (54.9–68.5) vs. 66.1 (59.7–72.7) years respectively, with a higher incidence of previous MI and percutaneous intervention. Patients from the group II had a higher incidence of hypertension, diabetes, obesity, atrial fibrillation, New York Heart Association class III or more. The incidence of the composite endpoints did not vary significantly between the two groups during the entire period after the index hospitalization, but patients from the group I had a lower mortality rate both within three and five years after discharge (8.5% vs. 10.7, p = 0.03 and 13.2% vs. 17.9%, p < 0.001, respectively).

Conclusions: Patients treated during 2006–2007 and 2015–2016 differed in age, clinical characteristics, and comorbidities. The composite endpoint incidence was similar in both groups, but long-term mortality rates were higher in the 2015–2016 cohort.