{"title":"泰国一家三级医疗中心慢性心力衰竭患者接受他汀类药物治疗的患病率和预测因素。","authors":"Pattamawan Kosuma, Arom Jedsadayanmata","doi":"10.1177/1179546819855656","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.</p><p><strong>Results: </strong>A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, <i>P</i> = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, <i>P</i> < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, <i>P</i> < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, <i>P</i> < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, <i>P</i> = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, <i>P</i> < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, <i>P</i> < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, <i>P</i> = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, <i>P</i> = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, <i>P</i> < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/9f/10.1177_1179546819855656.PMC6558538.pdf","citationCount":"0","resultStr":"{\"title\":\"Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand.\",\"authors\":\"Pattamawan Kosuma, Arom Jedsadayanmata\",\"doi\":\"10.1177/1179546819855656\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.</p><p><strong>Results: </strong>A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, <i>P</i> = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, <i>P</i> < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, <i>P</i> < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, <i>P</i> < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, <i>P</i> = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, <i>P</i> < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, <i>P</i> < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, <i>P</i> = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, <i>P</i> = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, <i>P</i> < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.</p>\",\"PeriodicalId\":10419,\"journal\":{\"name\":\"Clinical Medicine Insights. Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2019-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/9f/10.1177_1179546819855656.PMC6558538.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Medicine Insights. 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引用次数: 0
摘要
背景：他汀类药物在预防动脉粥样硬化性血管疾病方面发挥着重要作用，但其对慢性心力衰竭（CHF）患者的益处尚不确定。本研究旨在调查他汀类药物治疗的流行率和预测因素，以更好地了解他汀类药物在慢性心力衰竭患者中的处方模式：我们在泰国一家三级教学医院的附属门诊部对首次诊断为 CHF 的患者进行了横断面研究。数据来自电子索赔数据库。采用多变量逻辑回归法确定他汀类药物治疗的独立预测因素：本研究共纳入 3445 名患者。其中，1908 名患者（55.4%）接受了他汀类药物治疗，大部分患者（89.7%）每天服用辛伐他汀 20 毫克。与他汀类药物治疗独立相关的因素包括：男性（几率比 [OR] = 1.21，95% 置信区间 [CI] = 1.02-1.44，P = .03）；血脂异常诊断（OR = 4.88，95% CI = 3.88-6.14，P P P = .01）；接受血管紧张素转换酶抑制剂（OR = 3.44，95% CI = 2.87-4.13，P P = .004）、有机硝酸盐（OR = 2.04，95% CI = 1.16-3.58，P = .01）、β-受体阻滞剂（OR = 1.51，95% CI = 1.23-1.84，P P = .002）：结论：半数以上新确诊的慢性阻塞性肺疾病患者服用了他汀类药物。他汀类药物治疗的独立预测因素包括高胆固醇血症、表明动脉粥样硬化血管高风险的合并症以及推荐作为CHF患者心血管保护疗法的药物。
Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand.
Background: Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.
Methods: We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.
Results: A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, P = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, P < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, P < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, P < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, P = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, P < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, P < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, P = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, P = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, P < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, P = .002).
Conclusions: Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.
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