Gong Xiao-Huan, Yu Jin-Ming, Mao Yong, Hu Da-Yi
Key Laboratory of Public Health Safety, Ministry of Education, Centre for Clinical Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Heart Center, Peking University People's Hospital, Peking 100044, China.
J Transl Int Med. 2016 Apr 1;4(1):25-28. doi: 10.1515/jtim-2016-0006. Epub 2016 Apr 14.
To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS.
A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI.
A lower incidence rate ( < 0.05) was noted for efficacy and safety in patients with unstable angina (UA) than those with non-ST-segment elevation myocardial infarction (NSTE-MI). The prescription rate of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), fondaparinux, PCI, and single medication was 0.61%, 66.42%, 30.61%, 69.64%, and 70.74%, respectively.
Compared with NSTE-MI, UA is featured with better prognosis, less severity, and different outcome. However, in clinical practice, the therapies for NSTE-MI and UA show no differences, which deserves great attention. In China, the most common anticoagulant therapies for NSTE-ACS are single medication, mainly based on LMWH and PCI.
评估中国非ST段抬高型急性冠状动脉综合征(NSTE-ACS)的抗凝治疗情况,并为制定合理策略以改善NSTE-ACS的预后提供依据。
2009年12月至2011年12月期间,从中国14个省市的28家三级医院招募了1502例NSTE-ACS患者。各医院分别决定的诊断和治疗策略用于进一步分析和比较用药、经皮冠状动脉介入治疗(PCI)以及PCI术后9天和30天的疗效和安全性评估终点。
不稳定型心绞痛(UA)患者的疗效和安全性发生率低于非ST段抬高型心肌梗死(NSTE-MI)患者(<0.05)。普通肝素(UFH)、低分子肝素(LMWH)、磺达肝癸钠、PCI和单一用药的处方率分别为0.61%、66.42%、30.61%、69.64%和70.74%。
与NSTE-MI相比,UA的预后更好,病情较轻,结局不同。然而,在临床实践中,NSTE-MI和UA的治疗并无差异,这值得高度关注。在中国,NSTE-ACS最常见的抗凝治疗是单一用药,主要基于LMWH和PCI。