Sanfélix Gabriel, Peiró Salvador, Gosalbes Soler Victoria, Cervera Casino Pedro
Escuela Valenciana de Estudios de la Salud, Valencia, España.
Aten Primaria. 2006 Sep 30;38(5):250-7. doi: 10.1157/13092980.
To describe the use of ischaemic heart disease (IHD) secondary prevention measures in the Spanish National Health System.
Systematic review of observational studies with information on the use of preventive treatment and measures in the prevention of secondary IHD.
Primary care and specialised out-patient clinics.
Medline search and complementary searches of studies published between 1995 and 2004 with a description of the use secondary prevention measures on hospital discharge or in the follow up after discharge.
A total of 125 references were found after the MEDLINE search, 13 of which were selected after an independent review by 2 researchers. The complementary sources provided 9 more studies giving a total of 22.
One researcher extracted information on the characteristics of the study and the results variables, which were independently verified by a second evaluator. RESULTS. In the 22 studies found, a high level of variation was shown in the different treatment rates: anti-aggregants (at discharge, 72%-97.1%; follow-up, 46.4%-93.8%); beta-blockers (at discharge, 29%-68.3%; follow-up, 22.4%-59.0%); drugs with action on the renin-angiotensin system (at discharge, 16.2%-52.2%; follow-up, 6.1%-53.1%); lipid lowering drugs (at discharge, 6.7%-88.7%; follow-up, 24.5%-89.5%). The treatment rates showed a progressive improvement over time during the period studied.
In the period 1994-2003 treatment rates in the secondary prevention of IHD have increased, although there is still much room for improvement.
描述西班牙国家卫生系统中缺血性心脏病（IHD）二级预防措施的使用情况。
对关于预防性治疗及预防IHD二级预防措施使用情况的观察性研究进行系统评价。
初级保健机构和专科门诊。
检索Medline并对1995年至2004年发表的研究进行补充检索，这些研究描述了出院时或出院后随访中二级预防措施的使用情况。
经Medline检索共找到125篇参考文献，其中13篇经2名研究人员独立评审后入选。补充检索又提供了9项研究，共计22项。
一名研究人员提取关于研究特征和结果变量的信息，由另一名评估人员独立核实。结果：在找到的22项研究中，不同治疗率显示出高度差异：抗血小板药物（出院时，72% - 97.1%；随访时，46.4% - 93.8%）；β受体阻滞剂（出院时，29% - 68.3%；随访时，22.4% - 59.0%）；作用于肾素 - 血管紧张素系统的药物（出院时，16.2% - 52.2%；随访时，6.1% - 53.1%）；降脂药物（出院时，6.7% - 88.7%；随访时，24.5% - 89.5%）。在所研究期间，治疗率随时间逐步提高。
在1994 - 2003年期间，IHD二级预防的治疗率有所提高，尽管仍有很大的改进空间。
