Division of Cardiology, S. Giovanni Evangelista Hospital, Tivoli, Roma, Italy.
Division of Preventive Cardiology, SS Giovanni di Dio e Ruggi d'Aragona Hospital, University of Salerno, Italy.
Int J Cardiol. 2018 Dec 15;273:8-14. doi: 10.1016/j.ijcard.2018.08.055. Epub 2018 Aug 19.
To describe the contemporary management by cardiologists of patients after an episode of myocardial infarction (MI).
The EYESHOT Post-MI was a prospective, observational, nationwide study aimed to evaluate the management of patients referring to cardiologists 1 to 3 years from the last MI event.
Over a 3-month period, 1633 consecutive patients [median 22 (IQR 15-28) months from MI] were enrolled: 1028 (63.0%) at the second and 605 (37.0%) at the third year from MI. During the 12 months prior to enrolment, the majority of patients received a transthoracic echocardiogram (60% and 54%), followed by coronary angiography (24% and 16%, in the second and third year from MI groups, respectively). At the time of enrolment, the majority of patients were prescribed on statins (93%) and beta-blockers (82%), without significant differences between the 2 groups. A dual antiplatelet therapy (DAPT) was used more frequently among patients presenting during the second compared to the third year from MI (40% vs 24%; p < 0.0001). At multivariable analysis, the time interval from last MI (2 vs 3 years: OR 2.27; 95% CI 1.79-2.88; p < 0.0001) and a previous percutaneous coronary intervention with multiple stents (OR 3.46; 95% CI 2.19-5.47; p < 0.0001) resulted as the major independent predictors of DAPT persistence at the time of enrolment.
This contemporary registry provides unique insights into the current management of post-MI patients and represents an opportunity to further improve the long-term treatment of this high-risk population.
描述心肌梗死后（MI）患者经心内科医生治疗的当代管理情况。
EYESHOT Post-MI 是一项前瞻性、观察性的全国性研究，旨在评估距上次 MI 事件 1 至 3 年就诊于心内科医生的患者的管理情况。
在 3 个月的时间里，连续纳入 1633 例患者[距 MI 的中位数时间为 22（IQR 15-28）个月]：1028 例（63.0%）在第 2 年，605 例（37.0%）在第 3 年。在入组前 12 个月内，大多数患者接受了经胸超声心动图（60%和 54%，分别在第 2 年和第 3 年组），其次是冠状动脉造影（24%和 16%）。入组时，大多数患者服用他汀类药物（93%）和β受体阻滞剂（82%），两组间无显著差异。与第 3 年相比，第 2 年就诊的患者更常接受双联抗血小板治疗（DAPT）（40% vs 24%；p<0.0001）。多变量分析显示，距上次 MI 的时间间隔（2 年 vs 3 年：OR 2.27；95%CI 1.79-2.88；p<0.0001）和既往接受过多支架经皮冠状动脉介入治疗（OR 3.46；95%CI 2.19-5.47；p<0.0001）是入组时 DAPT 持续存在的主要独立预测因素。
本当代注册研究提供了 MI 后患者当前治疗的独特见解，是进一步改善该高危人群长期治疗的机会。
