Manckoundia Patrick, Buzens Jean-Baptiste, Mahmoudi Rachid, d'Athis Philippe, Martin Isabelle, Laborde Caroline, Menu Didier, Putot Alain
Pôle Personnes Âgées, Hospital of Champmaillot, University Hospital, Dijon, France.
UMR Inserm/U1093 Cognition, Action Sensorimotor Plasticity, University of Burgundy Franche Comté, Dijon, France.
Int J Clin Pract. 2017 Dec;71(12). doi: 10.1111/ijcp.13020. Epub 2017 Sep 21.
Despite the frequent use of antiplatelet medication (AM) in the elderly patients, very few studies have investigated its prescription. We describe AM prescription through retrospective study in ambulatory elderly patients.
All subjects aged over 80 years with a medical prescription delivered in March 2015 and affiliated to the Mutualité Sociale Agricole de Bourgogne. Subjects with prescriptions for AM were compared with those without.
A total of 15 141 ambulatory elderly patients (83-89 years, 61.3% of women) were included and 4412 (29.14%) had a prescription for AM. The latter were more frequently men than those without AM (43% vs 36.93%, P < .0001) and more frequently had chronic comorbidities (77.24% vs 64.65%, P < .0001). Compared with ambulatory subjects without AM, those with AM more frequently had coronary heart disease (35.15% vs 14.49%), severe hypertension (30% vs 25.65%), diabetes (27.42% vs 20.64%), peripheral arterial diseases (16.28% vs 5.96%) and disabling stroke (9% vs 5.56% (all P < .0001). In addition, they had more prescriptions of beta-blockers (45.24% vs 36.90%), angiotensin conversion enzyme inhibitor (31.35% vs 25.44%), calcium channel blockers (33.34% vs 27.90%), nitrate derivatives (10.6% vs 6.03%) or hypolipidemic agents (HA; 49.81% vs 29.72%) (all P < .0001) than those without AM.
In this study, which is very interested for its size and the advanced age of the subjects, long-course AM was prescribed in one third of ambulatory elderly patients. Coronary heart disease, severe hypertension and diabetes were more frequent in AM subjects. However, the low percentage of declared strokes was surprising. We provide additional data to doctors following subjects with AM.
尽管老年患者经常使用抗血小板药物（AM），但很少有研究调查其处方情况。我们通过对门诊老年患者的回顾性研究来描述AM的处方情况。
所有年龄在80岁以上、于2015年3月开具医疗处方且隶属于勃艮第社会农业互助会的患者。将开具AM处方的患者与未开具的患者进行比较。
共纳入15141名门诊老年患者（83 - 89岁，女性占61.3%），其中4412名（29.14%）有AM处方。与未使用AM的患者相比，使用AM的患者男性比例更高（43%对36.93%，P <.0001），且更常患有慢性合并症（77.24%对64.65%，P <.0001）。与未使用AM的门诊患者相比，使用AM的患者更常患有冠心病（35.15%对14.49%）、重度高血压（30%对25.65%）、糖尿病（27.42%对20.64%）、外周动脉疾病（16.28%对5.96%）和致残性中风（9%对5.56%（所有P <.0001））。此外，与未使用AM的患者相比，他们使用β受体阻滞剂（45.24%对36.90%）、血管紧张素转换酶抑制剂（31.35%对25.44%）、钙通道阻滞剂（33.34%对27.90%）、硝酸酯类衍生物（10.6%对6.03%）或降血脂药物（HA；49.81%对29.72%）的处方频率更高（所有P <.0001）。
在这项因其样本量和受试者高龄而极具意义的研究中，三分之一的门诊老年患者开具了长期AM处方。使用AM的患者中冠心病、重度高血压和糖尿病更为常见。然而，已申报中风的低比例令人惊讶。我们为跟踪使用AM的患者的医生提供了额外数据。
