急性冠状动脉综合征发生前给予高血压和缺血性心脏病患者最佳药物治疗的作用。

Role of Optimal Medication Given to Patients with Hypertension and Ischemic Heart Disease Prior to an Acute Coronary Syndrome.

作者信息

Pop Călin, Florescu Roberta, Matei Claudia, Pop Lavinia, Manea Viorel, Cotoraci Coralia, Mos Liana, Petris Antoniu

机构信息

Department of Cardiology, Emergency County Hospital, Baia Mare - Romania.

West University "Vasile Goldis" - Faculty of Medicine, Arad - Romania.

出版信息

Heart Int. 2017 Oct 14;12(1). doi: 10.5301/heartint.5000237. eCollection 2017 Jan-Dec.

DOI:10.5301/heartint.5000237

PMID:30263100

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6159667/

Abstract

INTRODUCTION

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).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

引言

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。

方法

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。

结果

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）。