接受经皮冠状动脉介入治疗患者的药物治疗：ROSETTA注册研究结果

Medical therapy in patients undergoing percutaneous coronary intervention: results from the ROSETTA registry.

作者信息

Eisenberg Mark J, Okrainec Karen, Lefkovits Jeffrey, Goudreau Evelyne, Deligonul Ubeydullah, Mak Koon-Hou, Duerr Robert, Tsang Janius, Huynh Thao, Sedlis Steven, Brown David L, Brieger David, Pilote Louise

机构信息

Jewish General Hospital/McGill University, Montreal, Canada.

出版信息

Can J Cardiol. 2003 Aug;19(9):1009-15.

PMID:12915928

Abstract

BACKGROUND

Previous studies have examined medication use among patients with coronary artery disease who have suffered an acute myocardial infarction (MI). However, little is known about medication use among patients with coronary artery disease who undergo percutaneous coronary intervention (PCI).

OBJECTIVE

To examine the patterns of use of medical therapy among patients who undergo PCI; and to examine the determinants of medical therapy in these patients.

METHODS

The Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) registry is a prospective multicentre study examining the use of functional testing after PCI. The medication use was examined among 787 patients who were enrolled in the ROSETTA registry at 13 clinical centres in five countries.

RESULTS

Most patients were men (mean age 61+/-11 years, 76% male) who underwent single vessel PCI (85%) with stent implantation (58%). At admission, discharge and six months, rates of acetylsalicylic acid use were 77%, 96% and 93%, respectively (discharge versus six months, P<0.0001). Rates of use of other oral antiplatelet agents were 11%, 59% and 2% (P=0.02). For individual anti-ischemic medications, rates of use were as follows: beta-blockers 49%, 58% and 59% (P<0.0001); calcium antagonists 34%, 43% and 42% (P<0.0001); and nitrates 42%, 56% and 43% (P<0.0001). Rates of use of combination anti-ischemic medications were as follows: triple therapy 7%, 9% and 9% (P<0.0001); double therapy 34%, 47% and 38% (P<0.0001); monotherapy 36%, 36% and 41% (P<0.0001); and no anti-ischemic therapy 23%, 8% and 12% (P<0.0001). Rates of use of angiotensin-converting enzyme inhibitors were 25%, 33% and 32% (P<0.0001), and rates of use of lipid lowering agents were 41%, 52% and 61% (P<0.0001).

CONCLUSIONS

Trials and guidelines statements have favourably affected the rates of use of acetylsalicylic acid and other antiplatelet agents after PCI. However, in spite of patients undergoing a successful revascularization procedure, physicians do not reduce the use of anti-ischemic medical therapy.

摘要

背景

既往研究已对发生急性心肌梗死（MI）的冠心病患者的药物使用情况进行了调查。然而，对于接受经皮冠状动脉介入治疗（PCI）的冠心病患者的药物使用情况知之甚少。

目的

研究接受PCI患者的药物治疗模式；并探讨这些患者药物治疗的决定因素。

方法

血管成形术后常规与选择性运动平板试验（ROSETTA）注册研究是一项前瞻性多中心研究，旨在调查PCI术后功能测试的使用情况。对在五个国家13个临床中心纳入ROSETTA注册研究的787例患者的药物使用情况进行了调查。

结果

大多数患者为男性（平均年龄61±11岁，76%为男性），接受单支血管PCI（85%）并植入支架（58%）。入院时、出院时和六个月时，阿司匹林的使用率分别为77%、96%和93%（出院时与六个月时相比，P<0.0001）。其他口服抗血小板药物的使用率分别为11%、59%和2%（P=0.02）。对于个体抗缺血药物，使用率如下：β受体阻滞剂49%、58%和59%（P<0.0001）；钙拮抗剂34%、43%和42%（P<0.0001）；硝酸盐类药物42%、56%和43%（P<0.0001）。联合抗缺血药物的使用率如下：三联疗法7%、9%和9%（P<0.0001）；双联疗法34%、47%和38%（P<0.0001）；单药治疗36%、36%和41%（P<0.0001）；未进行抗缺血治疗23%、8%和12%（P<0.0001）。血管紧张素转换酶抑制剂的使用率分别为25%、33%和32%（P<0.0001），降脂药物的使用率分别为41%、52%和61%（P<0.0001）。