Pop Călin, Florescu Roberta, Matei Claudia, Pop Lavinia, Manea Viorel, Cotoraci Coralia, Mos Liana, Petris Antoniu
Department of Cardiology, Emergency County Hospital, Baia Mare - Romania.
West University "Vasile Goldis" - Faculty of Medicine, Arad - Romania.
Heart Int. 2017 Oct 14;12(1). doi: 10.5301/heartint.5000237. eCollection 2017 Jan-Dec.
Administering optimal cardiovascular medication (OCM) to patients with hypertension (HBP) and ischemic heart disease (IHD) lowers cardiovascular morbidity and mortality.The main objective of this study was to compare in-hospital cardiac mortality among patients with HBP and/or IHD, treated or untreated with OCM, who developed a first episode of acute coronary syndrome (ACS).
The study was carried out retrospectively and included patients admitted with a first episode of ACS between 2013 and 2016. The patients were divided into three groups: those with HBP, IHD, and a history of HBP + IHD. Patients were then divided into two subgroups: subgroup A consisted of patients undergoing optimal anti-ischemic and/or antihypertensive therapy, while subgroup B consisted of patients without OCM.
This analysis comprised 1096 patients. Mean age was 64.3 ± 18 years. There were 581 patients in subgroup A - 53%, and 515 patients in subgroup B - 47%. Total cardiac mortality was 9.98%, different depending on the groups and subgroups studied: HBP group total - 7%, subgroup A - 5.1%, significantly lower compared to subgroup B - 9.4% (p = 0.05); IHD group total - 12.2%, subgroup A - 9.07%, significantly lower compared to subgroup B - 15.8% (p = 0.05); HBP + IHD group total - 14.35%, subgroup A - 9.9%, significantly lower compared to subgroup B - 18.8% (p = 0.05).
The lack of OCM in patients with HBP and/or IHD is correlated to a significant increase in in-hospital cardiac mortality among patients who develop a first-episode ACS.
对高血压（HBP）和缺血性心脏病（IHD）患者使用最佳心血管药物（OCM）可降低心血管疾病的发病率和死亡率。本研究的主要目的是比较首次发生急性冠状动脉综合征（ACS）的HBP和/或IHD患者，无论是否接受OCM治疗，其院内心脏死亡率。
本研究为回顾性研究，纳入2013年至2016年间因首次发作ACS入院的患者。患者分为三组：HBP组、IHD组和有HBP + IHD病史组。然后将患者分为两个亚组：A亚组由接受最佳抗缺血和/或抗高血压治疗的患者组成，而B亚组由未接受OCM治疗的患者组成。
本分析共纳入1096例患者。平均年龄为64.3±18岁。A亚组有581例患者（53%），B亚组有515例患者（47%）。总心脏死亡率为9.98%，根据所研究的组和亚组不同而有所差异：HBP组总死亡率为7%，A亚组为5.1%，显著低于B亚组的9.4%（p = 0.05）；IHD组总死亡率为12.2%，A亚组为9.07%，显著低于B亚组的15.8%（p = 0.05）；HBP + IHD组总死亡率为14.35%，A亚组为9.9%，显著低于B亚组的18.8%（p = 0.05）。
HBP和/或IHD患者未使用OCM与首次发作ACS患者的院内心脏死亡率显著增加相关。
