Danchin N, Thébaut J F, Diévart F, Grenier O, Mihci E, Herrmann M A, Ferrières J
Service de cardiologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Ann Cardiol Angeiol (Paris). 2007 Jan;56(1):30-5. doi: 10.1016/j.ancard.2006.10.002.
The interaction between the use of percutaneous coronary intervention (PCI) for non-ST-elevation acute coronary syndromes and the use of secondary prevention medications was analysed in the French S-Témoin Registry.
The population consisted of 2433 patients seen by their cardiologists at an outpatient clinic 2-12 months after non ST-elevation ACS; the survey was carried out from September 2004 to April 2005.
Overall, patients undergoing PCI (75% of the population) had higher levels of prescription of recommended secondary prevention medications. Multivariate logistic regression analysis showed that the use and type of coronary intervention (drug eluting versus bare metal stents) was an independent correlate of the use of dual antiplatelet therapy. In addition, time from the acute episode was also a strong correlate of dual antiplatelet therapy. Statins were also more often used in patients with PCI.
Patients not treated with PCI are less likely to receive appropriate secondary prevention medications after non ST-elevation acute coronary syndromes. Specific efforts should be directed towards these patients, in particular as regards the prescription of dual antiplatelet therapy.
在法国S-Témoin注册研究中，分析了非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗（PCI）的使用与二级预防药物使用之间的相互作用。
研究人群包括2433例在非ST段抬高型急性冠状动脉综合征发生后2至12个月于门诊就诊的心脏病专家诊治的患者；调查于2004年9月至2005年4月进行。
总体而言，接受PCI治疗的患者（占研究人群的75%）推荐的二级预防药物处方水平更高。多因素逻辑回归分析显示，冠状动脉介入治疗的使用及类型（药物洗脱支架与裸金属支架）是双联抗血小板治疗使用的独立相关因素。此外，距急性发作的时间也是双联抗血小板治疗的一个强相关因素。他汀类药物在接受PCI治疗的患者中也更常使用。
未接受PCI治疗的患者在非ST段抬高型急性冠状动脉综合征后接受适当二级预防药物治疗的可能性较小。应针对这些患者做出特别努力，尤其是在双联抗血小板治疗的处方方面。
