依从药物治疗二级预防冠心病：一项基于登记的前瞻性研究

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian heart journal Pub Date : 2025-03-01 DOI:10.1016/j.ihj.2025.02.009

Aradhai Bana , Krishna Kumar Sharma , Soneil Guptha , Rajeev Gupta

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引用次数: 0

摘要

背景和目的：在印度，急性冠脉综合征（ACS）后二级预防用药的数据有限。我们进行了一项基于登记的研究，以评估ACS住院后推荐药物的依从性。方法：招募连续入院的ACS患者。统计数据、基线特征、住院干预和规定的二级预防治疗（抗血小板、他汀类药物、β -受体阻滞剂、血管紧张素转换酶抑制剂（ACEI）、血管紧张素受体阻滞剂（ARB）和钙通道阻滞剂（CCB））出院时记录。使用经过验证的工具进行6个月的随访以评估依从性。结果：共纳入716例患者；平均年龄60.4±11岁，714例（99.7%）行经皮冠状动脉成形术，未行搭桥手术。出院时，心脏保护药物为：阿司匹林97.3%，双抗血小板99.7%，他汀类药物99.7%，受体阻滞剂74.2%,ACEI/ARB 38.8%, CCB 10.9%。554例患者可获得随访数据；死亡15例（2.1%），失访147例（20.5%）。6个月时用药状况及变化为阿司匹林83.9% (- 15.9%)；双重抗血小板70.2%(-29.5%),他汀类药物(-29.8%)70.0%,β受体阻断剂(-32.1%)50.4%,ACEI / ARB 22.4%(-42.3%)和中国建设银行(-36.7%)(p 80%)为42.7%,低24.4%,导致10.2%的坚持。拥有政府资助保险的患者比私人保险和自付的患者有更好的依从性。结论：急性冠脉综合征患者行PCI治疗后，6个月时对处方药物治疗的依从性不理想，各种药物的使用量下降了16- 42%。需要提高二级预防治疗依从性的战略。

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Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study

Background and objective

There is limited data on secondary prevention medications following acute coronary syndrome (ACS) in India. We performed a registry-based study to evaluate adherence to recommended medications following ACS hospitalisation.

Methods

Consecutive patients admitted with ACS were recruited. Data on demographics, baseline characteristics, in-hospital interventions, and prescribed secondary prevention therapies (antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB) at discharge were recorded. 6-months follow-up was conducted to evaluate adherence using validated tools.

Results

716 patients were recruited; the mean age was 60.4 ± 11 years, percutaneous coronary angioplasty (PCI) was performed in 714 (99.7 %) and bypass surgery in none. At hospital discharge, the cardioprotective medications were: aspirin 97.3 %, dual antiplatelets 99.7 %, statins 99.7 %, beta-blockers 74.2 %, ACEI/ARB 38.8 % and CCB 10.9 %. Follow-up data were available for 554 patients; 15 (2.1 %) died and 147 (20.5 %) were lost to follow-up. Medication status and change at 6 months was aspirin 83.9 % (−15.9 %); dual antiplatelets 70.2 % (−29.5 %), statins 70.0 % (−29.8 %), beta-blockers 50.4 % (−32.1 %), ACEI/ARB 22.4 % (−42.3 %) and CCB (−36.7 %) (p < 0.05). Use of high-intensity statins declined from 92.0 % to 45.7 % (−50.3 %). At follow-up, good adherence (>80 %) was 42.7 %, low adherence 24.4 % and non-adherence 10.2 %. Patients with government-sponsored insurance had better adherence than privately insured and self-paying.

Conclusions

Following acute coronary syndrome and PCI, the adherence to prescribed pharmacotherapy is sub-optimal at 6 months with a decline in various medications of 16–42 %. Strategies to increase adherence to secondary prevention therapies are required.

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来源期刊

Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

52 days

期刊介绍： Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.