中国的患者在出院时急性冠脉综合征住院后一年间的循证药物使用中国(CPACS)的研究精选.pdfVIP

Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: Results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study Yufang Bi, MM, a Runlin Gao, MD, FACC, b Anushka Patel, MB, BS, SM, PhD, FRACP, a Steve Su, BCom, BSc(Hons), PhD, a Wei Gao, MD, c Dayi Hu, MD, FACC, FHRS, FESC, d Dejia Huang, MD, e Lingzhi Kong, MD, f Wenhang Qi, MD, g Yangfeng Wu, MD, PhD, h Yuejin Yang, MD, b and Fiona Turnbull, MB ChB, MPH (Hons), FAFPHM a on behalf of the CPACS Investigators Sydney, Australia; and Beijing, Sichuan, and Shanghai, China Background Coronary heart disease has emerged as a leading cause of death in China. Although there is strong evidence for the use of antiplatelet, blood pressure–lowering, and lipid-lowering therapy in patients with acute coronary syndromes, the extent to which these medications are used in China remains uncertain. Methods We conducted a multicenter prospective study using data from consecutive patients diagnosed with suspected acute myocardial infarction or unstable angina pectoris admitted to the inpatient wards during the recruitment period. Medication adherence and reasons for nonadherence were reported using standardized questionnaires. Logistic regression was used to identify important patient and hospital characteristics associated with use of medication at 6 and 12 months after hospital discharge. Results The use of drug therapy was high (above 90% for aspirin, 70% for β-blockers and angiotensin-converting enzyme inhibitors, 80% for statin) at the time of hospital discharge but decreased during follow-up. However, fewer than half (48%) of patients were discharged on 4-drug combination therapy (antiplatelet, β-blocker, angiotensin-converting enzyme inhibitor/ angiotensin receptor blocker, and statin), and the proportion remai