Béraut E, Cambou J P, Guilhem J M, Vaysse N, Labro S, Séverac D, Boccalon H, Bura-Rivière A
Service de médecine vasculaire, pôle cardiovasculaire et métabolique, CHU Rangueil, 1, avenue du Pr Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
J Mal Vasc. 2008 Feb;33(1):1-11. doi: 10.1016/j.jmv.2007.09.005. Epub 2008 Jan 9.
Peripheral arterial disease (PAD) is a frequent and serious condition with a risk of mortality comparable to that of certain cancers. However, in France, the literature on this medical condition is scarce and data on management, incidence of complications and prognosis are lacking.
The COPART I registry, set up in June 2004, in the Vascular Medicine Department of the University Hospital of Toulouse, France, constitutes an observational database on hospitalized patients with PAD, in order to evaluate management, follow-up and prognosis of the patients. The aim of the present work is to compare medical prescriptions at hospital discharge, with the recent guidelines of the French High Authority of Health.
All consecutive patients with PAD, hospitalized in the Vascular Medicine Department of the University of Toulouse, between June 1, 2004 and July 31, 2006 were included. Only surviving patients were analysed.
Four hundred patients were included in the study. As expected, the majority were male (70%). Common cardiovascular risk factors were: arterial hypertension (66.7%), dyslipidemia (58.9%), diabetes (42.9%), and smoking (27.4%). Three patients out of 10 had claudication intermittens, nearly two out of 10 patients complained of persistent pain, and four out of 10 patients had Leriche and Fontaine stage IV arteriopathy. At hospital discharge, 86.9% of the patients were taking at least one antiplatelet treatment, 71.2% a statin, 54% a renin-angiotensin-system inhibitor. Nearly 66% of the patients (65.8%) received at least one antiplatelet agent and a statin. Nearly 50% of the patients (49.4%) had the three drugs recommended by the French High Authority of Health. We observed a change in prescription practices for statins (+30%), as well as for prescription of evidence-based tri-therapy (+29%) between 2004 and 2006.
Treatments prescribed at hospital discharge of patient with PAD included in the COPART I registry are in compliance with the French High Authority of Health guidelines concerning antiplatelet drugs and statins. Inhibitors of the renin-angiotensin system seem insufficiently used. However, favorable trends in medical practices between 2004 and 2006 have been observed.
外周动脉疾病（PAD）是一种常见且严重的疾病，其死亡风险与某些癌症相当。然而，在法国，关于这种疾病的文献稀缺，缺乏有关管理、并发症发生率和预后的数据。
2004年6月在法国图卢兹大学医院血管医学科建立的COPART I注册研究构成了一个关于PAD住院患者的观察数据库，以评估患者的管理、随访和预后。本研究的目的是将出院时的药物处方与法国卫生高级管理局的最新指南进行比较。
纳入2004年6月1日至2006年7月31日期间在图卢兹大学血管医学科住院的所有连续PAD患者。仅对存活患者进行分析。
400名患者纳入研究。正如预期的那样，大多数为男性（70%）。常见的心血管危险因素有：动脉高血压（66.7%）、血脂异常（58.9%）、糖尿病（42.9%）和吸烟（27.4%）。十分之三的患者有间歇性跛行，十分之二的患者抱怨持续疼痛，十分之四的患者有勒里什和方丹IV期动脉病变。出院时，86.9%的患者至少接受一种抗血小板治疗，71.2%接受他汀类药物治疗，54%接受肾素 - 血管紧张素系统抑制剂治疗。近66%的患者（65.8%）接受了至少一种抗血小板药物和一种他汀类药物。近50%的患者（49.4%）使用了法国卫生高级管理局推荐的三种药物。我们观察到2004年至2006年间他汀类药物的处方习惯有变化（+30%），以及循证三联疗法的处方也有变化（+29%）。
COPART I注册研究中纳入的PAD患者出院时所开的治疗符合法国卫生高级管理局关于抗血小板药物和他汀类药物的指南。肾素 - 血管紧张素系统抑制剂的使用似乎不足。然而，观察到2004年至2006年间医疗实践有积极趋势。
