Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients
Highlighting the need for better patient care in stable angina: results of the international Angina Treatment Patterns (ATP) Survey in 7074 patients
复制标题
DOI：
10.1093/fampra/cmh711
复制
发表时间：
2005-02-01
期刊：
影响因子：
2.2
通讯作者：
Freemantle, N
中科院分区：
文献类型：
--
作者：
Eastaugh, JL;Calvert, MJ;Freemantle, N
背景。稳定型心绞痛是世界范围内日益严重的问题。诊断方法和治疗方案已经建立，但实际实践的数据很少，并且早于当前的指导。 目标。将诊断和治疗信息与指南建议进行比较，并评估对生活质量的影响。方法。这项国际流行病学调查通过来自中国、捷克共和国、希腊、匈牙利、葡萄牙、俄罗斯和斯洛伐克共和国的初级和二级保健临床医生招募了患者。参与者在过去四个星期内至少经历过一次稳定型心绞痛。结果包括诊断技术的使用、药物治疗、手术干预、二级预防和生活质量。结果。该研究包括 7074 名患者，平均年龄 63.3 岁（标准差 10.3）。心绞痛的诊断最常见的原因是胸痛 (87.4%)，只有 54.9% 通过静息心电图确诊。尽管二级预防常常无效，41% 的已治疗高血压患者缺乏有效控制，但经常给出有关危险因素的建议。 97% 的患者至少正在服用指南推荐的一种稳定型心绞痛主要疗法，不同国家的个体疗法比例差异很大。在手术干预率低和药物治疗指南遵守率低的国家，生活质量最低。结论。结果表明，稳定型心绞痛患者的治疗不符合推荐标准，尽管这些指南在较贫穷国家的适用性需要进一步调查。总体而言，调查表明，改善医疗保健和危险因素管理将改善预后并提高生活质量。
Background. Stable angina is a growing problem worldwide. Diagnostic methods and treatment regimens are established but data on actual practice are sparse and pre-date current guidance.Objectives. To compare diagnosis and treatment information with guideline recommendations, and to assess impact on quality of life.Methods. This international epidemiological survey recruited patients through primary and secondary care clinicians from China, Czech Republic, Greece, Hungary, Portugal, Russia and Slovak Republic. Participants experienced at least one episode of stable angina within the previous four weeks. Outcomes included use of diagnostic techniques, pharmacological treatments, surgical intervention, secondary prevention and quality of life.Results. The study included 7074 patients, average age 63.3 (sd 10.3). Diagnosis of angina was most frequently as a result of chest pains (87.4%) with confirmaton by resting ECG in only 54.9%. Advice regarding risk factors was frequently given although secondary prevention was often ineffective with 41% of treated hypertensives lacking effective control. 97% of patients were taking at least one of the primary therapies for stable angina recommended by the guidelines with rates of individual therapies varying greatly across countries. Quality of life was lowest in countries with low rates of surgical intervention and poor observance of guidelines on pharmaceutical therapy.Conclusion. Results show that the management of patients with stable angina does not meet recommended standards, although the appropriateness of these guidelines in poorer countries needs further investigation. Overall, the survey indicates that improved medical care and risk factor management would enhance prognosis and improve quality of life.