Clinical opportunities and healthcare impact of optimal treatment in the post-ACS patient
DOI:
https://doi.org/10.33393/grhta.2022.2391Keywords:
Acute coronary syndrome, Adherence, Anti-thrombotic therapy, Cardiological rehabilitation, Diagnostictherapeutic assistance paths, Myocardial infarction, RevascularizationAbstract
Despite the improvement of revascularization procedures, patients with acute coronary syndrome often develop recurrent ischemic events, suggesting a high residual cardiovascular risk in these patients, which requires a strict clinical monitoring as well as an optimal control of modifiable risk factors.
To this aim, an optimal management of index event and appropriate preventive measures are equally important. Hospital care by cardiologists should be followed by outpatient management by general practitioners, as established by specific diagnostic and therapeutic pathways, which should warrant an optimal support to the patient. A strict collaboration between hospital and primary care is crucial to monitor and adapt drug therapy after the acute event and improve adherence of the patients to prescribed treatments and implementation of life-style modifications, with benefits also in term of cost-effectiveness. In this context, individualized rehabilitation programs should also be offered to patients with acute coronary syndromes, in order to improve survival and quality of life.
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Bhatt DL, Eagle KA, Ohman EM, et al; REACH Registry Investigators. Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. JAMA. 2010;304(12):1350-1357. https://doi.org/10.1001/jama.2010.1322PMID:20805624 DOI: https://doi.org/10.1001/jama.2010.1322
Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon M. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. Eur Heart J. 2015;36(19):1163-1170. https://doi.org/10.1093/eurheartj/ehu505 PMID:25586123 DOI: https://doi.org/10.1093/eurheartj/ehu505
Li S, Peng Y, Wang X, et al. Cardiovascular events and death after myocardial infarction or ischemic stroke in an older Medicare population. Clin Cardiol. 2019;42(3):391-399. https://doi.org/10.1002/clc.23160 PMID:30697776 DOI: https://doi.org/10.1002/clc.23160
Piepoli MF, Corrà U, Dendale P, et al. Challenges in secondary prevention after acute myocardial infarction: A call for action. Eur J Prev Cardiol. 2016;23(18):1994-2006. https://doi.org/10.1177/2047487316663873 PMID:27600690 DOI: https://doi.org/10.1177/2047487316663873
Newman JD, Alexander KP, Gu X, et al. Baseline Predictors of Low-Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial. Circ Cardiovasc Qual Outcomes. 2019;12(11):e006002. https://doi.org/10.1161/CIRCOUTCOMES.119.006002 PMID:31718297 DOI: https://doi.org/10.1161/CIRCOUTCOMES.119.006002
Ronco R, Corrao G. [Acute coronary syndrome: real-world data from the Lombardy Region]. G Ital Cardiol (Rome). 2019;20(10)(suppl 2):e8-e12. PMID:31618194
Urbinati S, Olivari Z, Gonzini L, et al; BLITZ-4 Investigators. Secondary prevention after acute myocardial infarction: drug adherence, treatment goals, and predictors of health lifestyle habits. The BLITZ-4 Registry. Eur J Prev Cardiol. 2015;22(12):1548-1556. https://doi.org/10.1177/2047487314561876 PMID:25452625 DOI: https://doi.org/10.1177/2047487314561876
Ilardi F, Ferrone M, Avvedimento M, Servillo G, Gargiulo G. Complete Revascularization in Acute and Chronic Coronary Syndrome. Cardiol Clin. 2020;38(4):491-505. https://doi.org/10.1016/j.ccl.2020.06.003 PMID:33036712 DOI: https://doi.org/10.1016/j.ccl.2020.06.003
Knuuti J, Wijns W, Saraste A, et al; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407-477. https://doi.org/10.1093/eurheartj/ehz425 PMID:31504439 DOI: https://doi.org/10.1093/eurheartj/ehz425
Collet JP, Thiele H, Barbato E, et al; ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-1367. https://doi.org/10.1093/eurheartj/ehaa575 PMID:32860058 DOI: https://doi.org/10.1093/eurheartj/ehaa575
Ibanez B, James S, Agewall S, et al; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-177. https://doi.org/10.1093/eurheartj/ehx393 PMID:28886621 DOI: https://doi.org/10.1093/eurheartj/ehx393
Greco C, Bovenzi FM, Berti S, et al. Documento ANMCO/GICR-IACPR/GISE L’organizzazione dell’assistenza nella fase post-acuta delle sindromi coronariche. G Ital Cardiol (Rome). 2014;15:3S-27S.
Koskinas KC, Mach F, Räber L. Lipid-lowering therapy and percutaneous coronary interventions. EuroIntervention. 2021;16(17):1389-1403. https://doi.org/10.4244/EIJ-D-20-00999PMID:33875408 DOI: https://doi.org/10.4244/EIJ-D-20-00999
Borén J, Chapman MJ, Krauss RM, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2020;41(24):2313-2330. https://doi.org/10.1093/eurheartj/ehz962 PMID:32052833 DOI: https://doi.org/10.1093/eurheartj/ehz962
Ference BA, Ginsberg HN, Graham I, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017;38(32):2459-2472. https://doi.org/10.1093/eurheartj/ehx144 PMID:28444290 DOI: https://doi.org/10.1093/eurheartj/ehx144
Koskinas KC, Siontis GCM, Piccolo R, et al. Effect of statins and non-statin LDL-lowering medications on cardiovascular outcomes in secondary prevention: a meta-analysis of randomized trials. Eur Heart J. 2018;39(14):1172-1180. https://doi.org/10.1093/eurheartj/ehx566PMID:29069377 DOI: https://doi.org/10.1093/eurheartj/ehx566
Cannon CP, Braunwald E, McCabe CH, et al; Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004;350(15):1495-1504. https://doi.org/10.1056/NEJMoa040583 PMID:15007110 DOI: https://doi.org/10.1056/NEJMoa040583
Ray KK, Cannon CP, McCabe CH, et al; PROVE IT-TIMI 22 Investigators. Early and late benefits of high-dose atorvastatin in patients with acute coronary syndromes: results from the PROVE IT-TIMI 22 trial. J Am Coll Cardiol. 2005;46(8):1405-1410. https://doi.org/10.1016/j.jacc.2005.03.077 PMID:16226162 DOI: https://doi.org/10.1016/j.jacc.2005.03.077
Cannon CP, Blazing MA, Giugliano RP, et al; IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med. 2015;372(25):2387-2397. https://doi.org/10.1056/NEJMoa1410489 PMID:26039521 DOI: https://doi.org/10.1056/NEJMoa1410489
Masiero G, Franzone A, Silvestri T, et al. [PCSK9 inhibitor use in high cardiovascular risk patients: an interventionalist’s overview on efficacy, current recommendations and factual prescription]. G Ital Cardiol (Rome). 2020;21(4):264-270. PMID:32202557
Sabatine MS, Giugliano RP, Keech AC, et al; FOURIER Steering Committee and Investigators. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376(18):1713-1722. https://doi.org/10.1056/NEJMoa1615664 PMID:28304224 DOI: https://doi.org/10.1056/NEJMoa1615664
Schwartz GG, Steg PG, Szarek M, et al; ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379(22):2097-2107. https://doi.org/10.1056/NEJMoa1801174 PMID:30403574 DOI: https://doi.org/10.1056/NEJMoa1801174
De Backer G, Jankowski P, Kotseva K, et al; EUROASPIRE V collaborators; Writing Committee; Scientific Steering/ Executive Committee; Coordinating centre; Diabetes centre; Data management centre; Statistical analysis centre; Central laboratory; Study centres, organisations, investigators and other research personnel (National Co-ordinators in each country are indicated by asterisk. Management of dyslipidaemia in patients with coronary heart disease: results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis. 2019;285:135-146. https://doi.org/10.1016/j.atherosclerosis.2019.03.014 PMID:31054483 DOI: https://doi.org/10.1016/j.atherosclerosis.2019.03.014
Danchin N, Almahmeed W, Al-Rasadi K, et al; ICLPS Investigators. Achievement of low-density lipoprotein cholesterol goals in 18 countries outside Western Europe: The International ChoLesterol management Practice Study (ICLPS). Eur J Prev Cardiol. 2018;25(10):1087-1094. https://doi.org/10.1177/2047487318777079 PMID:29771156 DOI: https://doi.org/10.1177/2047487318777079
Ray KK, Molemans B, Schoonen WM, et al. EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study. Eur J Prev Cardiol. 2021;28(11):1279-1289. https://doi.org/10.1093/eurjpc/zwaa047 PMID:33580789 DOI: https://doi.org/10.1093/eurjpc/zwaa047
Mach F, Baigent C, Catapano AL, et al; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-188. https://doi.org/10.1093/eurheartj/ehz455 PMID:31504418 DOI: https://doi.org/10.1093/eurheartj/ehz455
Valgimigli M, Bueno H, Byrne RA, et al; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2018;39(3):213-260. https://doi.org/10.1093/eurheartj/ehx419 PMID:28886622 DOI: https://doi.org/10.1093/eurheartj/ehx419
Gargiulo G, Valgimigli M, Capodanno D, Bittl JA. State of the art: duration of dual antiplatelet therapy after percutaneous coronary intervention and coronary stent implantation - past, present and future perspectives. EuroIntervention. 2017;13(6):717-733. https://doi.org/10.4244/EIJ-D-17-00468 PMID:28844033 DOI: https://doi.org/10.4244/EIJ-D-17-00468
Gargiulo G, Esposito G. Consolidating the value of the standardised ARC-HBR definition. EuroIntervention. 2021;16(14):1126-1128. https://doi.org/10.4244/EIJV16I14A202PMID:33605880 DOI: https://doi.org/10.4244/EIJV16I14A202
Mauri L, Kereiakes DJ, Yeh RW, et al; DAPT Study Investigators. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med. 2014;371(23):2155-2166. https://doi.org/10.1056/NEJMoa1409312 PMID:25399658 DOI: https://doi.org/10.1056/NEJMoa1409312
Yeh RW, Secemsky EA, Kereiakes DJ, et al; DAPT Study Investigators. Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention. JAMA. 2016;315(16):1735-1749. https://doi.org/10.1001/jama.2016.3775 PMID:27022822 DOI: https://doi.org/10.1001/jama.2016.3775
Piccolo R, Gargiulo G, Franzone A, et al. Use of the Dual-Antiplatelet Therapy Score to Guide Treatment Duration After Percutaneous Coronary Intervention. Ann Intern Med. 2017;167(1):17-25. https://doi.org/10.7326/M16-2389 PMID:28605779 DOI: https://doi.org/10.7326/M16-2389
Bonaca MP, Bhatt DL, Cohen M, et al; PEGASUS-TIMI 54 Steering Committee and Investigators. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med. 2015;372(19):1791-1800. https://doi.org/10.1056/NEJMoa1500857 PMID:25773268 DOI: https://doi.org/10.1056/NEJMoa1500857
Dellborg M, Bonaca MP, Storey RF, et al. Efficacy and safety with ticagrelor in patients with prior myocardial infarction in the approved European label: insights from PEGASUS-TIMI 54. Eur Heart J Cardiovasc Pharmacother. 2019;5(4):200-206. https://doi.org/10.1093/ehjcvp/pvz020PMID:31218354
Gargiulo G, Windecker S, Vranckx P, Gibson CM, Mehran R, Valgimigli M. A Critical Appraisal of Aspirin in Secondary Prevention: Is Less More? Circulation. 2016;134(23):1881-1906. https://doi.org/10.1161/CIRCULATIONAHA.116.023952 PMID:27920074 DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.023952
Vranckx P, Valgimigli M, Jüni P, et al; GLOBAL LEADERS Investigators. Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial. Lancet. 2018;392(10151):940-949. https://doi.org/10.1016/S0140-6736(18)31858-0 PMID:30166073 DOI: https://doi.org/10.1016/S0140-6736(18)31858-0
Franzone A, McFadden E, Leonardi S, et al; GLASSY Investigators. Ticagrelor Alone Versus Dual Antiplatelet Therapy From 1 Month After Drug-Eluting Coronary Stenting. J Am Coll Cardiol. 2019;74(18):2223-2234. https://doi.org/10.1016/j.jacc.2019.08.1038 PMID:31672177 DOI: https://doi.org/10.1016/j.jacc.2019.08.1038
Mehran R, Baber U, Sharma SK, et al. Ticagrelor with or without Aspirin in High-Risk Patients after PCI. N Engl J Med. 2019;381(21):2032-2042. https://doi.org/10.1056/NEJMoa1908419 PMID:31556978 DOI: https://doi.org/10.1056/NEJMoa1908419
Dangas G, Baber U, Sharma S, et al. Ticagrelor With or Without Aspirin After Complex PCI. J Am Coll Cardiol. 2020;75(19):2414-2424. https://doi.org/10.1016/j.jacc.2020.03.011PMID:32240761 DOI: https://doi.org/10.1016/j.jacc.2020.03.011
Angiolillo DJ, Baber U, Sartori S, et al. Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention. J Am Coll Cardiol. 2020;75(19):2403-2413. https://doi.org/10.1016/j.jacc.2020.03.008 PMID:32240760 DOI: https://doi.org/10.1016/j.jacc.2020.03.008
Kim BK, Hong SJ, Cho YH, et al; TICO Investigators. Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial. JAMA. 2020;323(23):2407-2416. https://doi.org/10.1001/jama.2020.7580 PMID:32543684 DOI: https://doi.org/10.1001/jama.2020.7580
Hahn JY, Song YB, Oh JH, et al; SMART-CHOICE Investigators. Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial. JAMA. 2019;321(24):2428-2437. https://doi.org/10.1001/jama.2019.8146 PMID:31237645 DOI: https://doi.org/10.1001/jama.2019.13163
Watanabe H, Domei T, Morimoto T, et al; STOPDAPT-2 Investigators. Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial. JAMA. 2019;321(24):2414-2427. https://doi.org/10.1001/jama.2019.8145PMID:31237644 DOI: https://doi.org/10.1001/jama.2019.8145
Giacoppo D, Matsuda Y, Fovino LN, et al. Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs. prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials. Eur Heart J. 2021;42(4):308-319. https://doi.org/10.1093/eurheartj/ehaa739 PMID:33284979 DOI: https://doi.org/10.1093/eurheartj/ehaa739
Koo BK, Kang J, Park KW, et al; HOST-EXAM investigators. Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial. Lancet. 2021;397(10293):2487-2496. https://doi.org/10.1016/S0140-6736(21)01063-1 PMID:34010616 DOI: https://doi.org/10.1016/S0140-6736(21)01063-1
Gargiulo G, Goette A, Tijssen J, et al. Safety and efficacy outcomes of double vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials. Eur Heart J. 2019;40(46):3757-3767. https://doi.org/10.1093/eurheartj/ehz732 PMID:31651946 DOI: https://doi.org/10.1093/eurheartj/ehz732
Gargiulo G, Cannon CP, Gibson CM, et al. Safety and efficacy of double vs. triple antithrombotic therapy in patients with atrial fibrillation with or without acute coronary syndrome undergoing percutaneous coronary intervention: a collaborative meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials. Eur Heart J Cardiovasc Pharmacother. 2021;7(FI1):f50-f60. https://doi.org/10.1093/ehjcvp/pvaa116 PMID:33119069 DOI: https://doi.org/10.1093/ehjcvp/pvaa116
Galli M, Benenati S, Capodanno D, et al. Guided versus standard antiplatelet therapy in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. Lancet. 2021;397(10283):1470-1483. https://doi.org/10.1016/S0140-6736(21)00533-XPMID:33865495 DOI: https://doi.org/10.1016/S0140-6736(21)00533-X
Angiolillo DJ, Patti G, Chan KT, et al. De-escalation from ticagrelor to clopidogrel in acute coronary syndrome patients: a systematic review and meta-analysis. J Thromb Thrombolysis. 2019;48(1):1-10. https://doi.org/10.1007/s11239-019-01860-7 PMID:31004312 DOI: https://doi.org/10.1007/s11239-019-01860-7
Capodanno D, Bhatt DL, Eikelboom JW, et al. Dual-pathway inhibition for secondary and tertiary antithrombotic prevention in cardiovascular disease. Nat Rev Cardiol. 2020;17(4):242-257. https://doi.org/10.1038/s41569-019-0314-y PMID:31953535 DOI: https://doi.org/10.1038/s41569-019-0314-y
Eikelboom JW, Connolly SJ, Bosch J, et al; COMPASS Investigators. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319-1330. https://doi.org/10.1056/NEJMoa1709118 PMID:28844192 DOI: https://doi.org/10.1056/NEJMoa1709118
Connolly SJ, Eikelboom JW, Bosch J, et al; COMPASS investigators. Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet. 2018;391(10117):205-218. https://doi.org/10.1016/S0140-6736(17)32458-3 PMID:29132879 DOI: https://doi.org/10.1016/S0140-6736(17)32458-3
Anand SS, Bosch J, Eikelboom JW, et al; COMPASS Investigators. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet. 2018;391(10117):219-229. https://doi.org/10.1016/S0140-6736(17)32409-1 PMID:29132880 DOI: https://doi.org/10.1016/S0140-6736(17)32409-1
Anand SS, Eikelboom JW, Dyal L, et al; COMPASS Trial Investigators. Rivaroxaban Plus Aspirin Versus Aspirin in Relation to Vascular Risk in the COMPASS Trial. J Am Coll Cardiol. 2019;73(25):3271-3280. https://doi.org/10.1016/j.jacc.2019.02.079 PMID:31248548 DOI: https://doi.org/10.1016/j.jacc.2019.02.079
Pedretti RFE. [The rehabilitation phase]. G Ital Cardiol (Rome). 2019;20(10)(suppl 2):e17-e20. PMID:31618196
Piepoli MF, Hoes AW, Agewall S, et al; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315-2381. https://doi.org/10.1093/eurheartj/ehw106 PMID:27222591 DOI: https://doi.org/10.1093/eurheartj/ehw106
Doimo S, Fabris E, Piepoli M, et al. Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study. Eur Heart J. 2019;40(8):678-685. https://doi.org/10.1093/eurheartj/ehy417 PMID:30060037 DOI: https://doi.org/10.1093/eurheartj/ehy417
Scalvini S, Grossetti F, Paganoni AM, La Rovere MT, Pedretti RF, Frigerio M. Impact of in-hospital cardiac rehabilitation on mortality and readmissions in heart failure: A population study in Lombardy, Italy, from 2005 to 2012. Eur J Prev Cardiol. 2019;26(8):808-817. https://doi.org/10.1177/2047487319833512 PMID:30813817 DOI: https://doi.org/10.1177/2047487319833512
Kitzman DW, Whellan DJ, Duncan P, et al. Physical Rehabilitation for Older Patients Hospitalized for Heart Failure. N Engl J Med. 2021;385(3):203-216. https://doi.org/10.1056/NEJMoa2026141 PMID:33999544 DOI: https://doi.org/10.1056/NEJMoa2026141
Griffo R, Tramarin R, Volterrani M, et al; Società Italiana Cardiologia Ospedalita Accreditata. [The Italian Survey on Cardiac Rehabilitation - 2013 (ISYDE.13-Directory): national availability and organization of cardiac rehabilitation facilities]. G Ital Cardiol (Rome). 2016;17(3):217-224. PMID:27029880
Chowdhury R, Khan H, Heydon E, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013;34(38):2940-2948. https://doi.org/10.1093/eurheartj/eht295 PMID:23907142 DOI: https://doi.org/10.1093/eurheartj/eht295
Giannuzzi P, Temporelli PL, Marchioli R, et al; GOSPEL Investigators. Global secondary prevention strategies to limit event recurrence after myocardial infarction: results of the GOSPEL study, a multicenter, randomized controlled trial from the Italian Cardiac Rehabilitation Network. Arch Intern Med. 2008;168(20):2194-2204. https://doi.org/10.1001/archinte.168.20.2194PMID:19001195 DOI: https://doi.org/10.1001/archinte.168.20.2194
Spandonaro F. Aspetti farmacoeconomici. (Progetto Consensus – La gestione ottimale del paziente con sindrome coronarica acuta). Online https://atbv.it/progetto-consensus-la-gestione-ottimale-del-paziente-sindrome-coronarica-acuta/ (Accesssed February 2022).
Bhatt DL, Briggs AH, Reed SD, et al; ODYSSEY OUTCOMES Investigators. Cost-Effectiveness of Alirocumab in Patients With Acute Coronary Syndromes: the ODYSSEY OUTCOMES Trial. J Am Coll Cardiol. 2020;75(18):2297-2308. https://doi.org/10.1016/j.jacc.2020.03.029 PMID:32381160 DOI: https://doi.org/10.1016/j.jacc.2020.03.029
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