Abstract 17097: Substantial Improvement of Primary Cardiovascular Prevention by a Systematic Score-based Multimodal and Lifestyle Approach: A Randomized Endpoint-Study - The Preford-Study
Background: The optimization of primary preventive cardiovascular (CV) strategies is urgently needed. The objective of the present study was to evaluate the long-term effects of a standardized multimodal and lifestyle based therapeutic approach in high-risk-subjects according to the ESC-SCORE on predefined cardiovascular end-points. The ESC-SCORE allows a systematic estimation of the 10-year-risk for fatal CV events.
Methods: The individual CV risk was assessed in a cohort of 4.196 employees of the Ford-Company, Germany, using the ESC-SCORE. Subjects were subsequently classified into three risk-groups. Subjects at high-risk, (ESC-SCORE ≥ 5%; n=447), were randomized either into a multimodal 15-week lifestyle based outpatient intervention program (INT n=224) or into a usual care group (UC n=223) and followed up for 36 months. The primary endpoint was a reduction of the ESC-SCORE in the INT as compared to the UC at the end of the trial. Secondary endpoints were a composite of fatal and non-fatal CV events (coronary artery disease, cerebrovascular or peripheral arterial disease, CV death and total mortality) and the time to the first CV event. An intention to treat analysis was performed.
Results: After 36 months a difference of the ESC-SCORE development favoring the INT was achieved (INT: 8.70 to 10.03% vs. UC: 8.49 to 12.09%; p<0.016). Moreover, a reduction in the composite secondary endpoint was observed (INT: n=11 vs. UC: n=27; p=0.032; HR 0.45 (CI 0.22 - 0.94).
Conclusions: Our results demonstrate an intermediate-term improvement of the ESC-SCORE as well as a reduction of predefined CV endpoints by a primary CV prevention program within 36 months in a cohort of persons determined to be at high CV risk by assessment with the ESC-SCORE.
Author Disclosures: H. Predel: Other Research Support; Significant; Bayer Healthcare Germany. Honoraria; Significant; UCB Pharma Company Germany. D.B. Gysan: None. C. Albus: None. B. Bjarnason-Wehrens: None. H. Gohlke: None. J. Latsch: None. S. Millentrup: None. C. Heming: None. G. Herold: None.
- © 2015 by American Heart Association, Inc.