Receipt of cardiac medications upon discharge among men and women with acute coronary syndrome and nonobstructive coronary artery disease.
Receipt of cardiac medications upon discharge among men and women with acute coronary syndrome and nonobstructive coronary artery disease.
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DOI：
10.1002/clc.20701
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发表时间：
2010-01
影响因子：
2.7
通讯作者：
Jackson, Elizabeth A.
中科院分区：
文献类型：
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作者：
Ramanath, Vijay S.;Armstrong, David F.;Grzybowski, Mary;Rahnama-Mohagdam, Sahand;Tamhane, Umesh U.;Gordon, Kelly;Froehlich, James B.;Eagle, Kim A.;Jackson, Elizabeth A.
急性冠状动脉综合征（ACS）非梗阻性心外膜冠状动脉疾病（CAD）患者的管理仍然知之甚少。非梗阻性CAD的ACS患者在出院时接受有效心脏药物治疗的可能性较小。我们确定了因ACS住院的患者，这些患者接受了冠状动脉造影并进行了6个月的随访。患者按CAD严重程度分组：非阻塞性CAD（所有血管阻塞<50%）或阻塞性CAD（≥1条血管阻塞≥50%）。收集所有患者的人口统计学资料、出院时的药物治疗和6个月时的不良结局。在纳入研究的2，264例ACS患者中：123例患者患有非梗阻性CAD，2，141例患有梗阻性CAD。心脏危险因素包括高血压和糖尿病在非梗阻性CAD患者中很常见。与梗阻性CAD患者相比，非梗阻性CAD男性和女性患者接受心脏药物治疗的可能性更低，包括阿司匹林（87.8% vs. 95.0%，p=0.001）、β受体阻滞剂（74.0% vs. 89.2%，p<0.001）或他汀类药物（69.1% vs. 81.2%，p=0.001）。在非梗阻性CAD患者中，未观察到出院药物的性别相关差异。然而，患有非梗阻性CAD的女性与患有梗阻性CAD的男性的心脏相关再住院率相似（分别为23.3%和25.9%）。与梗阻性CAD患者相比，非梗阻性CAD患者接受循证药物治疗的可能性更低，尽管存在CAD风险因素和ACS事件。需要进一步研究以确定非梗阻性CAD患者接受有效的心脏药物治疗是否会减少心脏相关事件。
Management of acute coronary syndrome (ACS) patients with non-obstructive epicardial coronary artery disease (CAD) remains poorly understood. ACS patients with non-obstructive CAD are less likely to receive effective cardiac medications upon discharge from the hospital. We identified patients hospitalized with ACS that underwent coronary angiography and had 6-month follow-up. Patients were grouped by CAD severity: non-obstructive CAD (<50% blockage in all vessels) or obstructive CAD (≥50% blockage in ≥1 vessels). Data were collected on demographics, medications at discharge, and adverse outcomes at 6 months, for all patients. Of the 2,264 ACS patients included in the study: 123 patients had non-obstructive CAD and 2,141 had obstructive CAD. Cardiac risk factors including hypertension and diabetes were common among patients with non-obstructive CAD. Men and women with non-obstructive CAD were less likely to receive cardiac medications compared to patients with obstructive CAD including aspirin (87.8% vs. 95.0%, p=0.001), beta-blockers (74.0% vs. 89.2%, p<0.001), or statins (69.1% vs. 81.2%, p=0.001). No gender-related differences in discharge medications were observed for patients with nonobstructive CAD. However women with non-obstructive CAD had similar rates of cardiac-related rehospitalization as men with obstructive CAD (23.3% and 25.9%, respectively). Patients with non-obstructive CAD are less likely to receive evidence-based medications compared to patients with obstructive CAD, despite the presence of CAD risk factors and occurrence of an ACS event. Further research is warranted to determine if receipt of effective cardiac medications among patients with non-obstructive CAD would reduce cardiac related events.
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影响因子：
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作者：
Bugiardini, Raffaele;Manfrini, Olivia;De Ferrari, Gaetano M.
通讯作者：
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影响因子：
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通讯作者：
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影响因子：
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通讯作者：
Skene, AM