Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2011;64:179-85 - Vol. 64 Num.03 DOI: 10.1016/j.rec.2010.07.002

Impact of Comprehensive and Intensive Treatment of Risk Factors Concerning Cardiovascular Mortality in Secondary Prevention: MIRVAS Study

Miguel A. Moreno-Palanco a,, Patricia Ibáñez-Sanz a, Cristina Ciria-de Pablo b, Alberto Pizarro-Portillo a, Francisco Rodríguez-Salvanés c, Carmen Suárez-Fernández a

a Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, Spain
b Atención Primaria, Área 2 de Salud, Madrid, Spain
c Fundación Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain

Refers to

Keywords

Myocardial infarction. Stroke. Arterial hypertension. Survival.

Abstract

Introduction and objectives

The aim was to determine whether secondary prevention involving the comprehensive and intensive treatment of cardiovascular risk factors reduces cardiovascular events and cardiovascular mortality at 3-year follow up.

Methods

The study design comprised a randomized, controlled, open trial in a routine clinical practice setting. In total, 247 patients who presented with acute coronary syndrome or stroke were selected. They were randomized to comprehensive and intensive treatment of cardiovascular risk factors (n=121) or to follow-up based on usual care (n=126). The main study outcomes were the number of cardiovascular events and cardiovascular mortality at 3-year follow-up. The percentage of patients in whom each risk factor was successfully controlled was a secondary outcome.

Results

Overall, 88.8% of patients assigned to the intensive treatment group had a low-density lipoprotein cholesterol level <100mg dl compared with 56 4 of the usual-care group relative risk rr 95 confidence interval ci 1 28-1 93 and 75 7 diabetics had a hemoglobin 1c <7 compared with 28 6 of the usual-care group rr="2.65;" 95 ci 1 13-6 19 there were four deaths due to cardiovascular causes and 26 nonfatal events in intensive treatment versus 17 54 cumulative survival rate at 3 years was 97 4 intervention 85 5 control P=.003).

Conclusions

Secondary prevention involving comprehensive and intensive treatment of cardiovascular risk factors reduced both morbidity and mortality at 3-year follow up.

1885-5857/© 2011 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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