Achievement of optimal medical therapy goals for U.S. adults with coronary artery disease: results from the REGARDS Study (REasons for Geographic And Racial Differences in Stroke)

• Published in: Journal of the American College of Cardiology 2014-04, Vol.63 (16), p.1626
• Main Authors: Brown, Todd M, Voeks, Jenifer H, Bittner, Vera, Brenner, David A, Cushman, Mary, Goff, Jr, David C, Glasser, Stephen, Muntner, Paul, Tabereaux, Paul B, Safford, Monika M
• Format: Article
• Language: English
• Subjects: Aged; Coronary Artery Disease - ethnology; Coronary Artery Disease - therapy; Female; Fibrinolytic Agents - therapeutic use; Follow-Up Studies; Goals; Humans; Incidence; Male; Middle Aged; Outcome Assessment, Health Care; Percutaneous Coronary Intervention - methods; Prospective Studies; Racial Groups; Stroke - ethnology; Stroke - etiology; Stroke - prevention & control; Survival Rate - trends; Thrombolytic Therapy - methods; United States - epidemiology
• ISSN: 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2013.12.042

In a nonclinical trial setting, we sought to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation) trial. In the COURAGE trial, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. The REGARDS (REasons for Geographic And Racial Differences in Stroke) study is a national prospective cohort study of 30,239 African-American and white community-dwelling individuals older than 45 years of age who enrolled in 2003 through 2007. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on the COURAGE trial: 1) aspirin use; 2) systolic blood pressure