Treatment adherence in patients without ST-elevation acute coronary syndrome.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-04-01 Epub Date: 2023-07-05 DOI:10.23736/S2724-5683.23.06345-7

Lucía V Campos Cervera, Pierre Sabouret, Marco Bernardi, Luigi Spadafora, Maciej Banach, Florencia Muñoz, Marcos Viruel, Ezequiel J Zaidel, José Bonorino, Gonzalo Perez, Rosina Arbucci, Juan P Costabel

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引用次数: 0

Abstract

Background: Despite progress during the last decades, patients with coronary artery disease (CAD) remain with a high residual risk due to multiple reasons. Optimal medical treatment (OMT) provides a decrease of recurrent ischemic events after acute coronary syndrome (ACS). Therefore, treatment adherence results crucial to reduce further outcomes after the index event. No recent data are available in Argentinian population; the main objective of our study was to evaluate the adherence at 6 and 15 months in post non-ST elevation acute coronary syndrome (NST-ACS) consecutive patients. Secondary objective was to evaluate the relationship of adherence with 15-month events.

Methods: A prespecified sub-analysis in the prospective registry Buenos Aires I was performed. The adherence was evaluated using the modified Morisky-Green Scale.

Results: A number of 872 patients had information about adherence profile. Of them 76.4% were classified as adherents at month 6 and 83.6% at 15 (P=0.06). We did not find any difference in baseline characteristic between the adherent and non-adherent patients at 6 months. The adjusted analysis showed that non-adherent patients had a rate of ischemic events at 15^th month of 20% (27/135) vs. 11.5% (52/452) in adherent patients (P=0.001). The bleeding events defined were of 3.6% in the non-adherent group vs. 5% in the adherent group without a statistical difference (P=0.238).

Conclusions: Adherence to treatment is still a major issue as almost 25% of patients should be considered as non-adherent to OMT. No clinical predictor of this phenomenon was identified but our criteria were not exhaustive. Good adherence to treatment was highly associated to a reduction of ischemic events, whereas no impact on bleeding events was found. These data support a better network and collaboration with shared decision between healthcare professionals with patients and family members to improve acceptance and adherence to optimal medical strategies.

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无 ST 段抬高的急性冠状动脉综合征患者坚持治疗的情况。

背景：尽管在过去几十年中取得了进展，但由于多种原因，冠状动脉疾病（CAD）患者仍有很高的残余风险。最佳药物治疗（OMT）可减少急性冠状动脉综合征（ACS）后复发的缺血性事件。因此，坚持治疗对于减少急性冠脉综合征后的进一步后果至关重要。我们研究的主要目的是评估非 ST 段抬高急性冠脉综合征（NST-ACS）后连续患者 6 个月和 15 个月的治疗依从性。次要目标是评估依从性与 15 个月事件的关系：在前瞻性登记处布宜诺斯艾利斯 I 中进行了预设子分析。结果：872 名患者提供了相关信息：结果：872 名患者提供了依从性资料。其中 76.4% 的患者在第 6 个月时被归类为坚持治疗者，83.6% 的患者在第 15 个月时被归类为坚持治疗者（P=0.06）。我们没有发现坚持与未坚持治疗的患者在 6 个月时的基线特征有任何差异。调整后的分析显示，非依从患者在第15个月发生缺血性事件的比例为20%（27/135），而依从患者为11.5%（52/452）（P=0.001）。未坚持治疗组的出血事件发生率为3.6%，坚持治疗组为5%，无统计学差异（P=0.238）：坚持治疗仍是一个主要问题，因为近25%的患者应被视为不坚持OMT治疗。目前尚未发现这一现象的临床预测因素，但我们的标准并非详尽无遗。良好的治疗依从性与缺血性事件的减少密切相关，而对出血事件则没有影响。这些数据支持医护人员与患者和家属建立更好的网络和合作，共同做出决定，以提高对最佳医疗策略的接受度和依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.