• 中国核心期刊(遴选)数据库收录期刊
  • 中文科技期刊数据库收录期刊
  • 中国期刊全文数据库收录期刊
  • 中国学术期刊综合评价数据库统计源期刊等

中国药物评价 ›› 2021, Vol. 38 ›› Issue (1): 19-24.

• 药品评价 • 上一篇    下一篇

天津市新发急性冠脉综合征患者抗血小板用药依从性与持续性分析

刘鑫1, 贺小宁1, 丛洪良2, 卢成志3, 吴晶1*   

  1. 1. 天津大学药物科学与技术学院, 天津 300072;
    2. 天津市胸科医院, 天津 300051; 3. 天津市第一中心医院, 天津 300192
  • 收稿日期:2020-11-18 修回日期:2021-02-04 出版日期:2021-02-28 发布日期:2021-02-28

Adherence and Persistence with Antiplatelet Agents in Patients with New EpisodeP of Acute Coronary Syndrome in Tianjin

  1. 1. School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072;
    2. Tianjin Chest Hospital, Tianjin 300051,China; 3. Tianjin First Center Hospital, Tianjin 300192, China
  • Received:2020-11-18 Revised:2021-02-04 Online:2021-02-28 Published:2021-02-28

摘要: 目的:评估天津市新发急性冠脉综合征(ACS)患者二级预防期间抗血小板药物的依从性与持续性,并探究其影响因素。方法:使用天津市城镇职工基本医疗保险参保人30%随机抽样数据库,纳入2012年1月1日至2014年12月31日期间有过≥1次以ACS为主要出院诊断(ICD-10:I20.0,I21,I22),出院后30 d内有≥1次抗血小板药物处方且无任何不良心血管事件(心梗、卒中、死亡及其复合终点)的新发ACS患者,回顾性分析患者随访12个月用药依从性与持续性,并探究其影响因素。结果:识别到5 486名新发ACS患者(63.15±10.81岁;60.23%男性);出院后12个月内,患者平均依从天数占比(PDC)为39.17%±29.25%,仅有10.94%的患者依从用药,90.08%的患者发生抗血小板药物中断,平均持续用药天数为103.89±110.27天;男性、入组期间接受了经皮冠状动脉介入治疗(PCI)以及入组住院天数较长的患者依从性和持续性更好;另外,基线使用过钙通道阻滞剂的患者依从性更差,使用过β-受体阻滞剂的患者持续性更差。结论:天津市新发ACS患者抗血小板药物依从性、持续性较差;男性、入组住院期间接受了PCI手术以及入组住院天数较长的患者更加依从并持续用药。
    

关键词: font-size:medium, ">急性冠脉综合征;抗血小板药物;依从性;持续性;二级预防

Abstract: Objective: To investigate the adherence and persistence with antiplatelet agents and their associated factors among patients with new episode of acute coronary syndromes (ACS) in Tianjin, China. Methods: Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database. Adult patients who initiated with antiplatelet agents between January, 2012 to December, 2014, which occurred within a 30-day time window after discharge from the first hospitalization for ACS (index hospitalization) were included. Patients who had major adverse cardiovascular events (MACE) within the initial 30 days follow-up were further excluded. Adherence and persistence of antiplatelet agents were analyzed during the 12-month follow-up period and their associated factors were also investigated, respectively. Results: 5 486 patients (63.15±10.81 years; 60.23% male) were identified. Only 10.9% of them were adherent to antiplatelet agents during follow-up, and the mean proportion of days covered(PDC) was 39.17%±29.25% among the total cohort. 90.08% of patients discontinued antiplatelet agents and the average time to discontinuation was 103.89±110.27 days. Male, patients who received percutaneous coronary intervention (PCI) and patients who had longer stay during index hospitalization had better adherence and persistence. Furthermore, patients utilized calcium channel blockers (CCB) during baseline period were more likely to be adherent, while patients who prior used β-blockers had poorer persistence. Conclusion: Adherence and persistence to antiplatelet agents were unsatisfactory among the patients with new episode of ACS in Tianjin. Male, receiving PCI and longer stay during index hospitalization were associated with better adherence/persistence.
    

Key words: font-size:medium, ">Acute coronary syndromes; Antiplatelet agents; Adherence; Persistence; Secondary prevention

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