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抗血小板药物规范化管理及其对冠心病患者预后影响的研究

Investigation of standardized administration of anti-platelet drugs and its effect on the prognosis of patients with coronary heart disease.

作者信息

Ding Chao, Zhang Jianhua, Li Rongcheng, Wang Jiacai, Hu Yongcang, Chen Yanyan, Li Xiannan, Xu Yan

机构信息

Department of Cardiology, Lu'an Shili Hospital of Anhui, Lu'an, Anhui 237006, P.R. China.

Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, P.R. China.

出版信息

Exp Ther Med. 2017 Oct;14(4):3207-3212. doi: 10.3892/etm.2017.4903. Epub 2017 Aug 8.

Abstract

The aim of the present study was to explore the effect of adherence to standardized administration of anti-platelet drugs on the prognosis of patients with coronary heart disease. A total of 144 patients newly diagnosed with coronary heart disease at Lu'an Shili Hospital of Anhui Province (Lu'an, China) between June 2010 and June 2012 were followed up. Kaplan-Meier curves and the Cox regression model were used to evaluate the effects of standardized administration of anti-platelet drugs on primary and secondary end-point events. Of the patients with coronary heart disease, 109 (76%) patients took standard anti-platelet drugs following discharge. Kaplan-Meier curve and Cox regression analysis showed that standardized administration of anti-platelet drugs reduced the risk of primary end-point events (including all-cause mortality, non-lethal myocardial infarction and stroke) of patients with coronary heart disease [hazard ratio (HR)=0.307; 95% confidence interval (CI): 0.099-0.953; P=0.041) and all-cause mortality (HR=0.162; 95% CI: 0.029-0.890; P=0.036); however, standardized administration had no predictive value with regard to secondary end-point events. Standardized administration of anti-platelet drugs obviously reduced the risk of primary end-point events in patients with coronary heart disease, and further analysis showed that only all-cause mortality exhibited a statistically significant reduction.

摘要

本研究旨在探讨坚持抗血小板药物标准化给药对冠心病患者预后的影响。对2010年6月至2012年6月期间在安徽省六安市十里医院新诊断为冠心病的144例患者进行随访。采用Kaplan-Meier曲线和Cox回归模型评估抗血小板药物标准化给药对主要和次要终点事件的影响。在冠心病患者中,109例(76%)患者出院后服用标准抗血小板药物。Kaplan-Meier曲线和Cox回归分析表明,抗血小板药物标准化给药降低了冠心病患者主要终点事件(包括全因死亡率、非致死性心肌梗死和中风)的风险[风险比(HR)=0.307;95%置信区间(CI):0.099-0.953;P=0.041]和全因死亡率(HR=0.162;95%CI:0.029-0.890;P=0.036);然而,标准化给药对次要终点事件没有预测价值。抗血小板药物标准化给药明显降低了冠心病患者主要终点事件的风险,进一步分析表明只有全因死亡率有统计学意义的降低。

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