Ostör E, Jánosi A, Belatiny K A, Borbás S, Bradak A, Podmaniczky M
Gottsegen György Országos Kardiológiai Intézet, Budapest.
Orv Hetil. 1999 Jan 31;140(5):243-8.
The European Society of Cardiology, the European Atherosclerosis Society and the European Society of Hypertension published in 1994 a joint statement and recommendation on prevention of coronary heart disease in clinical practice. The EUROASPIRE study intended to investigate the present clinical practice in this respect in 9 European countries. The present paper deals with the Hungarian leg of the collaborative study. Hospital data of 546 patients below the age of 70 were reviewed of whom 29% were women. Consecutive patients were identified retrospectively with the following discharge-diagnoses: coronary bypass grafting, PTCA, acute myocardial infarction and angina pectoris. Minimum 6, in the average 18 month after the index event, patients were interviewed and examined. The participation rate was 77%. During the index hospitalisation an incomplete documentation of the main risk factors was found: blood pressure values were missing in 12%, lipid values in 48%, smoking status in 34%, body weight in 22% and family history in 46% of the cases, with wide variation between diagnostic categories. At follow-up 23% of the patients were obese (BMI > or = 30 kg/m2), 49% had elevated blood pressure (140/90 > or = Hgmm), 46% had total cholesterol above 5.5 mmol/l, 23% smoked and 27% were diabetic. 75% of the patients were on antiplatelet, 14% on anticoagulant, 58% on beta-blocking, 22% on lipid lowering, 32% on ACE-inhibitor and 44% on calcium channel blocking medication. The screening of first degree relatives was recommended in only 18% of the patients. The results speak for a substantial neglect of secondary prevention of coronary patients in the Hungarian clinical practice. However without complex detection, evaluation and management of risk factors it is impossible to reduce the recurrence and high mortality of coronary heart disease.
欧洲心脏病学会、欧洲动脉粥样硬化学会和欧洲高血压学会于1994年发表了一份关于临床实践中冠心病预防的联合声明和建议。EUROASPIRE研究旨在调查9个欧洲国家在这方面的当前临床实践情况。本文涉及该合作研究中的匈牙利部分。回顾了546名70岁以下患者的医院数据，其中29%为女性。通过以下出院诊断对连续患者进行回顾性识别：冠状动脉搭桥术、经皮冠状动脉腔内血管成形术（PTCA）、急性心肌梗死和心绞痛。在索引事件发生后至少6个月，平均18个月时对患者进行访谈和检查。参与率为77%。在索引住院期间，发现主要危险因素的记录不完整：12%的病例中血压值缺失，48%的病例中血脂值缺失，34%的病例中吸烟状况缺失，22%的病例中体重缺失，46%的病例中家族史缺失，不同诊断类别之间差异很大。在随访时，23%的患者肥胖（体重指数≥30kg/m²），49%的患者血压升高（收缩压/舒张压≥140/90mmHg），46%的患者总胆固醇高于5.5mmol/l，23%的患者吸烟，27%的患者患有糖尿病。75%的患者服用抗血小板药物，14%的患者服用抗凝药物，58%的患者服用β受体阻滞剂，22%的患者服用降脂药物，32%的患者服用血管紧张素转换酶抑制剂（ACE抑制剂），44%的患者服用钙通道阻滞剂。仅18%的患者被建议对一级亲属进行筛查。结果表明匈牙利临床实践中对冠心病患者的二级预防严重忽视。然而，没有对危险因素进行综合检测、评估和管理，就不可能降低冠心病的复发率和高死亡率。
