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@ARTICLE{Rehm:282428,
      author       = {M. Rehm and A. Jaensch and B. Schöttker$^*$ and U.
                      Mons$^*$ and H. Hahmann and W. Koenig and H. Brenner$^*$ and
                      D. Rothenbacher$^*$},
      title        = {{M}edical care and biomarker-based assessment of mortality
                      in two cohorts of patients with chronic coronary syndrome 10
                      years apart.},
      journal      = {BMC cardiovascular disorders},
      volume       = {23},
      number       = {1},
      issn         = {1471-2261},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2023-01755},
      pages        = {428},
      year         = {2023},
      note         = {#LA:C070#},
      abstract     = {This study aimed to describe the characteristics and
                      mortality of two cohorts of patients with chronic coronary
                      syndrome (CCS) recruited with identical study designs in the
                      same rehabilitation clinics but approximately 10 years
                      apart.The KAROLA cohorts included patients with CCS
                      participating in an inpatient cardiac rehabilitation
                      programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II:
                      2009-2011). Blood samples and information on
                      sociodemographic factors, lifestyle, and medical treatment
                      were collected at baseline, at the end of rehabilitation,
                      and after one year of follow-up. A biomarker-based risk
                      model (ABC-CHD model) and Cox regression analysis were used
                      to evaluate cardiovascular (CV) and non-CV mortality risk.We
                      included 1130 patients from KAROLA-I (mean age 58.7 years,
                      $84.4\%$ men) and 860 from KAROLA-II (mean age 60.4 years,
                      $83.4\%$ men). Patients in the KAROLA-I cohort had
                      significantly higher concentrations of CV biomarkers and
                      fewer patients were taking CV medications, except for
                      statins. The biomarker-based ABC-CHD model provided a higher
                      estimate of CV death risk for patients in the KAROLA-I
                      cohort (median 3-year risk, $3.8\%)$ than for patients in
                      the KAROLA-II cohort (median 3-year risk, $2.7\%,$ p-value
                      for difference < 0.001). After 10 years of follow-up, 91
                      $(8.1\%)$ patients in KAROLA-I and 45 $(5.2\%)$ in KAROLA-II
                      had died from a CV event.Advances in disease management over
                      the past 20 years may have led to modest improvements in
                      pharmacological treatment during cardiac rehabilitation and
                      long-term outpatient care for patients with CCS. However,
                      modifiable risk factors such as obesity have increased in
                      the more recent cohort and should be targeted to further
                      improve the prognosis of these patients.},
      keywords     = {Biomarkers (Other) / Cardiac rehabilitation (Other) /
                      Chronic coronary syndrome (Other) / Mortality (Other) /
                      Pharmacological treatment (Other) / Risk factors (Other)},
      cin          = {C070 / C120 / HD01 / M050},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)M050-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37644408},
      doi          = {10.1186/s12872-023-03469-4},
      url          = {https://inrepo02.dkfz.de/record/282428},
}