Pogosova N V, Oganov R G, Boytsov S A, Ausheva A K, Sokolova O J, Kursakov A A, Pozdnyakov Y M, Salbieva Ma O, Lelchuk I N, Gusarova T A, Gomyranova Mn V, Skazin N A, Yeliseeva N A, Akhmedova E B, Bedeynikova K K, Kovrigina M N
1National Research Center for Preventive Medicine, Moscow, Russia; 2City clinical hospital 36, Moscow, Russia.
Kardiologiia. 2015 Dec;55(12):99-107. doi: 10.18565/cardio.2015.12.99-107.
The results of the Russian part of the EUROASPIRE IV study show that we have a large room for improvement of traditional risk factors management in CAD patients hospitalized for acute myocardial infarction, acute coronary syndromes, PCI or CABG (at average in 1.7 years of follow-up after index events). It is also true for other European countries, although certain differences exist between Russian and whole study population. In some respects, the results of secondary prevention in Russian patients were even more successful: e.g. effective blood pressure control was achieved in 73.4% of our patients taking antihypertensive drugs vs 53.5% in whole study population. In contrast, smoking was more prevalent among Russian patients (22.2% vs 15.0% in other countries). Obviously, it was related to lower frequency of smoking cessation support offered to our patients: only 1.1% were referred to a smoking cessation program, 3.2% were prescribed nicotine replacement therapy, none were prescribed varenicline (vs 18.6, 22.9, 6.2%, respectively, in whole study population). The Russian cohort had the highest rate of overweight and obesity compared to other European countries (93.1 vs 82.1% in whole study population). 74.9% our patients received lipid lowering drugs (vs 86.6% in Europe), although the LDL-C goal was achieved only in 15.9% of our patients taking lipid lowering drugs (vs 21.1% in whole study population).
EUROASPIRE IV研究俄罗斯部分的结果表明,对于因急性心肌梗死、急性冠状动脉综合征、经皮冠状动脉介入治疗(PCI)或冠状动脉旁路移植术(CABG)住院的冠心病患者(在索引事件发生后的平均1.7年随访期内),我们在传统危险因素管理方面有很大的改进空间。其他欧洲国家也是如此,尽管俄罗斯与整个研究人群之间存在某些差异。在某些方面,俄罗斯患者二级预防的结果甚至更成功:例如,在服用抗高血压药物的患者中,73.4%的患者实现了有效的血压控制,而在整个研究人群中这一比例为53.5%。相比之下,吸烟在俄罗斯患者中更为普遍(22.2%,而其他国家为15.0%)。显然,这与为我们的患者提供的戒烟支持频率较低有关:只有1.1%的患者被转介到戒烟项目,3.2%的患者被开了尼古丁替代疗法,没有人被开伐尼克兰(而在整个研究人群中分别为18.6%、22.9%、6.2%)。与其他欧洲国家相比,俄罗斯队列中超重和肥胖率最高(93.1%,而整个研究人群为82.1%)。74.9%的患者接受了降脂药物治疗(欧洲为86.6%),尽管在服用降脂药物的患者中只有15.9%实现了低密度脂蛋白胆固醇(LDL-C)目标(整个研究人群为21.1%)。