Secondary prevention and risk factor target achievement in a global, high-risk population with established coronary heart disease: baseline results from the STABILITY study

Eur J Prev Cardiol. 2013 Aug;20(4):678-85. doi: 10.1177/2047487312444995. Epub 2012 Apr 10.


Aim: There is limited contemporary data on achievement of risk factor goals for secondary prevention of cardiovascular (CV) disease from countries in many regions of the world. This report describes the global and regional prevalence of CV risk factors and use of preventive medications at baseline in participants in the ongoing STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial.

Methods and results: Detailed individual data on CV risk factors were obtained before randomization in 15,828 patients with chronic coronary heart disease (CHD) from 39 countries on five continents. Subjects had a history of myocardial infarction, prior coronary revascularization, or multi-vessel CHD without revascularization and at least one additional CV risk factor. The majority were taking a statin (97%), antiplatelet therapy (96%), beta-blocker (79%), or angiotensin converting enzyme inhibitor/angiotensin receptor blocker (77%). However, a large proportion of patients did not achieve guideline-recommended targets. For instance, in 29% low-density lipoprotein (LDL) cholesterol was >2.5 mmol/l and in 46% blood pressure was ≥140/90 mmHg or ≥130/80 mmHg in those with diabetes or renal impairment. The body mass index was >30 kg/m(2) in 36%, waist circumference ≥102 cm for men or ≥88 cm for women in 54%, and 18% were smoking. Regional differences in risk factor prevalence and target achievement were observed and were more marked for LDL cholesterol and obesity.

Conclusion: The prevalence of modifiable CV risk factors was generally high in the STABILITY population. Although, most patients were receiving evidence-based secondary preventive therapy many subjects from all regions did not reach recommended secondary prevention goals.

Trial registration: NCT00799903.

Keywords: Cardiovascular risk factors; coronary heart disease; guideline recommendations; guidelines; secondary prevention.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Benzaldehydes / therapeutic use*
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Pressure
  • Cardiovascular Agents / therapeutic use*
  • Coronary Disease / blood
  • Coronary Disease / diagnosis
  • Coronary Disease / drug therapy*
  • Coronary Disease / epidemiology
  • Double-Blind Method
  • Female
  • Guideline Adherence
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Lipids / blood
  • Male
  • Middle Aged
  • Oximes / therapeutic use*
  • Phospholipase A2 Inhibitors / therapeutic use*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Secondary Prevention* / methods
  • Time Factors
  • Treatment Outcome


  • Benzaldehydes
  • Biomarkers
  • Blood Glucose
  • Cardiovascular Agents
  • Hypolipidemic Agents
  • Lipids
  • Oximes
  • Phospholipase A2 Inhibitors
  • darapladib

Associated data