Tomcsányi János
Betegápoló Irgalmasrend Budai Irgalmasrendi Kórháza Budapest, Árpád fejedelem u. 7., 1027.
Orv Hetil. 2017 Mar;158(12):443-446. doi: 10.1556/650.2017.30687.
Statin therapy has proven to be one cornerstone for prevention and treatment of cardiovascular disease, but the clinical application is suboptimal. Adherence to statin therapy in Hungary in primary prevention is very low, but not known in patients with myocardial infarction.
This study was designed to determine the statin and ezetimib adherence after myocardial infarction in respect of total mortality.
A retrospective study was carried out based on the National Health Insurance database between 2013-2015. Adherence was measured after minimum 6 months therapy and at least 80% statin prescription.
Total mortality rate after myocardial infarction was 12,7% after 6 months, 16,2% after one year and 21,7% after two years. Statin adherence after myocardial infarction reached 70%. The adherence was higher among patients with high dose than the modest dose statin therapy. Adherence with the combination of statin-ezetimibe therapy was lower than with statin monotherapy. Adherence with modest intensity statin-ezetimibe combination was only 40%. High intensity statin-ezetimibe combination resulted 66% adherence.
The myocardial infarction mortality remain high in the first two years. Adherence to high or modest dose statin is better than in primary prevention. The patient number on statin-ezetimibe combination is very low, which means that lot of patients are not on the target level of LDL cholesterin. Orv. Hetil., 2017, 158(12), 443-446.
他汀类药物治疗已被证明是预防和治疗心血管疾病的基石之一，但临床应用并不理想。匈牙利初级预防中他汀类药物治疗的依从性很低，但心肌梗死患者的依从性情况尚不清楚。
本研究旨在确定心肌梗死后他汀类药物和依泽替米贝在总死亡率方面的依从性。
基于2013 - 2015年国家健康保险数据库进行回顾性研究。在至少6个月治疗且他汀类药物处方率至少80%后测量依从性。
心肌梗死后6个月总死亡率为12.7%，1年后为16.2%，2年后为21.7%。心肌梗死后他汀类药物依从性达到70%。高剂量他汀类药物治疗患者的依从性高于中等剂量。他汀类药物与依泽替米贝联合治疗的依从性低于他汀类药物单药治疗。中等强度他汀类药物与依泽替米贝联合治疗的依从性仅为40%。高强度他汀类药物与依泽替米贝联合治疗的依从性为66%。
心肌梗死后头两年死亡率仍然很高。高剂量或中等剂量他汀类药物的依从性优于初级预防。接受他汀类药物与依泽替米贝联合治疗的患者数量非常少，这意味着许多患者的低密度脂蛋白胆固醇未达到目标水平。《匈牙利医学周报》，2017年，158(12)，443 - 446。
