Persistent Use of Secondary Preventive Drugs Declines Rapidly During the First 2 Years After Stroke
Persistent Use of Secondary Preventive Drugs Declines Rapidly During the First 2 Years After Stroke
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DOI：
10.1161/strokeaha.109.566950
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发表时间：
2010-02-01
期刊：
影响因子：
8.3
通讯作者：
Lundberg, Michael
中科院分区：
文献类型：
--
作者：
Glader, Eva-Lotta;Sjolander, Maria;Lundberg, Michael
背景与目的：为了预防卒中后发生新的心血管事件，应持续使用处方预防药物。这项研究测量了中风后预防性药物的持续使用，并确定了与持续使用相关的因素。方法：来自瑞典卒中登记系统Riks-Stroke的1年队列（21,077名幸存者）与瑞典处方药登记系统相关联。结果-出院时持续使用处方药物的患者比例在前2年内逐渐下降，降压药占74.2%，他汀类药物占56.1%，抗血小板药物占63.7%，华法林占45.0%。对于大多数药物，高龄、合并症、良好的自我感觉健康、没有低情绪、卒中单位的急性治疗和随访时的机构生活与持续用药独立相关。结论：持续二级预防治疗在中风后的头2年迅速下降，尤其是他汀类药物和华法林。需要开发有效的干预措施来改善脑卒中后的持续二级预防。（中国医学杂志。2010;41:397-401）
Background and Purpose-To prevent new cardiovascular events after stroke, prescribed preventive drugs should be used continuously. This study measures persistent use of preventive drugs after stroke and identifies factors associated with persistence.Methods-A 1-year cohort (21 077 survivors) from Riks-Stroke, the Swedish Stroke Register, was linked to the Swedish Prescribed Drug Register.Results-The proportion of patients who were persistent users of drugs prescribed at discharge from hospital declined progressively over the first 2 years to reach 74.2% for antihypertensive drugs, 56.1% for statins, 63.7% for antiplatelet drugs, and 45.0% for warfarin. For most drugs, advanced age, comorbidity, good self-perceived health, absence of low mood, acute treatment in a stroke unit, and institutional living at follow-up were independently associated with persistent medication use.Conclusion-Persistent secondary prevention treatment declines rapidly during the first 2 years after stroke, particularly for statins and warfarin. Effective interventions to improve persistent secondary prevention after stroke need to be developed. (Stroke. 2010; 41: 397-401.)