{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:23:42Z","timestamp":1791829422052,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"14","license":[{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Trial design<\/jats:title>\n                  <jats:p>Prospective randomized multicentre interventional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Individual cardiovascular risk assessment in Ford Company, Germany employees (n\u2009=\u20094.196), using the European Society of Cardiology-Systematic Coronary Risk Evaluation (ESC-SCORE) for classification into three risk groups. Subjects assigned to ESC high-risk group (ESC-SCORE\u2009\u2265\u20095%), without a history of cardiovascular disease were eligible for randomization to a multimodal 15-week intervention programme (INT) or to usual care and followed up for 36 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Evaluation of the long-term effects of a risk-adjusted multimodal intervention in high-risk subjects. Primary endpoint: reduction of ESC-SCORE in INT versus usual care. Secondary endpoints: composite of fatal and non-fatal cardiovascular events and time to first cardiovascular event. Statistical analysis: intention-to-treat and per-protocol analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Four hundred and forty-seven subjects were randomized to INT (n\u2009=\u2009224) or to usual care (n\u2009=\u2009223). After 36 months ESC-SCORE development favouring INT was observed (INT: 8.70% to 10.03% vs. usual care: 8.49% to 12.09%; p\u2009=\u20090.005; net difference: 18.50%). Moreover, a significant reduction in the composite cardiovascular events was observed: (INT: n\u2009=\u200911 vs. usual care: n\u2009=\u200927). Hazard ratio of intervention versus control was 0.51 (95% confidence interval 0.25\u20131.03; p\u2009=\u20090.062) in the intention-to-treat analysis and 0.41 (95% confidence interval 0.18\u20130.90; p\u2009=\u20090.026) in the per-protocol analysis, respectively. No intervention-related adverse events or side-effects were observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results demonstrate the efficiency of identifying cardiovascular high-risk subjects by the ESC-SCORE in order to enrol them to a risk adjusted primary prevention programme. This strategy resulted in a significant improvement of ESC-SCORE, as well as a reduction in predefined cardiovascular endpoints in the INT within 36 months. (ISRCTN 23536103.)<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487317718081","type":"journal-article","created":{"date-parts":[[2017,9,12]],"date-time":"2017-09-12T11:02:09Z","timestamp":1505214129000},"page":"1544-1554","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Substantial improvement of primary cardiovascular prevention by a systematic score-based multimodal approach: A randomized trial: The PreFord-Study"],"prefix":"10.1093","volume":"24","author":[{"given":"Detlef Bernd","family":"Gysan","sequence":"first","affiliation":[{"name":"Department of Human Medicine, Private University of Witten\/Herdecke GmbH, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Millentrup","sequence":"additional","affiliation":[{"name":"Outpatient Cardiac Rehabilitation Centre GmbH, Cologne, 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