Plotnick G D, Ziskind A A, Vogel R A
Department of Medicine, University of Maryland, Baltimore.
Am J Cardiol. 1992 Feb 1;69(4):327-30. doi: 10.1016/0002-9149(92)90228-q.
In November 1990, we surveyed 160 practicing community cardiologists in the state of Maryland and 20 academic cardiologists at the University of Maryland Medical Center to determine each individual's preference for aggressive versus nonaggressive therapy for various presentations of acute myocardial infarction. The survey was repeated in April 1991 following a report of the results of the Third International Study of Infarct Survival. All 100 responding cardiologists chose aggressive therapy to manage an early (less than 2 hours) acute anterior myocardial infarction in a 50-year-old patient. However, less aggressive therapy was chosen by many community cardiologists for management of early inferior acute myocardial infarction or for elderly patients. Most community cardiologists chose tissue plasminogen activator as their thrombolytic drug of choice, whereas university cardiologists favored streptokinase. Although there were substantial shifts in choice of thrombolytic agent on the repeat survey, most community physicians still chose tissue plasminogen activator over the less expensive streptokinase.
1990年11月，我们对马里兰州160名执业社区心脏病专家以及马里兰大学医学中心的20名学术心脏病专家进行了调查，以确定每个人对于急性心肌梗死不同表现形式采用积极治疗与非积极治疗的偏好。1991年4月，在第三次国际心肌梗死生存研究结果报告发布后，该项调查再次进行。所有100名做出回应的心脏病专家选择积极治疗来处理一名50岁患者早期（少于2小时）的急性前壁心肌梗死。然而，许多社区心脏病专家选择对早期下壁急性心肌梗死或老年患者采用不那么积极的治疗。大多数社区心脏病专家选择组织型纤溶酶原激活剂作为他们首选的溶栓药物，而大学心脏病专家则更青睐链激酶。尽管在重复调查中溶栓剂的选择有很大变化，但大多数社区医生仍然选择组织型纤溶酶原激活剂而非价格较低的链激酶。
