Prognosis at 6 Months for Coronary and Cerebrovascular Patients: Impact of Antiplatelet Agents and Statins: Results from the Prevenir III Study

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Abstract
Purpose: The aim of the Prevenir III study was to assess, in secondary prevention, the risk after 6 months of subsequent coronary and cerebrovascular events in a population of patients in private practice. Methods: A prospective observational survey, including patients diagnosed with previous myocardial infarction, unstable angina or stroke, was carried out by French general practitioners and cardiologists. Results: 9556 patients were selected by 3746 physicians representative of French physicians. The medical records of 8288 were analyzed. After a 6-month follow-up, 116 patients (1.4%) had been hospitalized for coronary or cerebrovascular event i.e. cumulative incidence 3.6 per 100 person-years (95% CI 2.9–4.2). The rate of coronary events was 0.9% and the cumulative incidence 2.3% person-years (95% CI 1.8–2.8), the event rate of stroke was 0.5% and the cumulative incidence 1.3 person-years (95% CI 0.9–1.7) and all-cause mortality was 1.2% i.e. 3.1 per 100 person-years (95% CI 2.5–3.7). Patients treated with statins and antiplatelet agents, or both, were less likely to undergo subsequent events than patients not receiving statins or antiplatelet agents. All-cause mortality rate decreased dramatically (Hazard Ratio 0.4 95% CI 0.2–0.7 after adjustment for age, sex, diagnosis at inclusion, time elapsed since the index event, cardiovascular and non cardiovascular history, betablockers, angiotensin-converting enzyme inhibitors and cardiovascular risk factors) in patients treated with a combination of statins and antiplatelet agents when compared to patients treated with neither statins nor antiplatelet agents. Conclusion: Our survey enabled a better understanding of the prognosis at 6 months in a large sample of coronary and cerebrovascular patients. We observed the beneficial impact of the combination of statins and antiplatelet agents in cardiovascular secondary prevention.

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