Management of patients with suspected angina, but without known myocardial infarction: a cross-sectional survey.
Management of patients with suspected angina, but without known myocardial infarction: a cross-sectional survey.
复制标题
疑似心绞痛但无已知心肌梗死患者的管理：一项横断面调查。
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
C. Cricelli
中科院分区：
文献类型：
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作者：
A. Filippi;G. Gensini;Angelo A Bignanimi;Andrea Sabatini;G. Mazzaglia;C. Cricelli
背景
尽管最近发表了几项研究，描述了全科医生对心肌梗死（MI）患者的诊断和治疗管理，但关于无MI的心绞痛患者的信息很少。
目的
描述一般实践中对无已知MI的心绞痛患者的管理。
设计
横向调查。
设置
意大利全科医生向健康搜索数据库提供数据。
方法
从健康搜索数据库中选择心绞痛的流行病例，使用硝酸盐处方作为疾病状态的“代理”，在没有已知MI的患者中。收集了患者人口统计学、临床信息、既定治疗和心脏病学访视的数据。进行二项逻辑回归分析，以测试哪个变量使处方更可能或更不可能。
结果
心绞痛患者10455例。73.8%的患者可获得血压读数;在该组中，58.9%的患者血压控制不充分（>或= 140/90 mmHg）。在61.6%的病例中记录了总胆固醇（平均值= 5.5 mmol/L）。67.8%的患者使用抗血小板或口服抗凝剂，24.1%的患者接受降脂药，61%的患者接受ACE抑制剂或血管紧张素II受体拮抗剂，25.2%的患者接受β受体阻滞剂。
结论
在接受硝酸盐治疗的患者中，对可改变的风险因素的监测和预防药物的使用低于预期。需要新的策略，旨在改善这些容易识别的高风险受试者的二级心血管预防。
BACKGROUND
Although several studies describing the diagnostic and therapeutic management of patients with myocardial infarction (MI) by general practitioners have recently been published, little information exists about patients with angina without MI.
AIM
To describe the management of patients with angina without known MI in general practice.
DESIGN
A cross-sectional survey.
SETTING
Italian general practitioners providing data to the Health Search Database.
METHOD
Prevalent cases of angina, using the prescription of nitrates as a 'proxy' for disease status, in patients without known MI were selected from the Health Search Database. Data on patient demographics, clinical information, established therapies and cardiology visits were collected. A binomial logistic regression analysis was performed to test which variable made prescription more or less likely.
RESULTS
There were 10 455 patients with angina. Blood pressure readings were available for 73.8% of patients; in this group 58.9% had inadequate (> or = 140/90 mmHg) blood pressure control. Total cholesterol was recorded in 61.6% of cases (mean value = 5.5 mmol/L). Antiplatelet or oral anticoagulant agents were used by 67.8% of the patients, while 24.1% of patients received lipid-lowering agents, 61% received ACE-inhibitors or angiotensin-II receptor antagonists, and 25.2% received beta-blockers.
CONCLUSIONS
In patients treated with nitrates the monitoring of modifiable risk factors and the use of preventive drugs is lower than expected. New strategies aimed at improving secondary cardiovascular prevention among these easily identifiable high-risk subjects are needed.