Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Ghent University Hospital, Ghent, Belgium.
Int J Cardiol. 2020 Feb 1;300:7-13. doi: 10.1016/j.ijcard.2019.09.015. Epub 2019 Sep 7.
As advised by the European guidelines on cardiovascular prevention, medication intake is a major component of secondary prevention. The aim of this study is to provide an in-depth overview of the medication intake in stable European coronary heart disease (CHD) patients.
Analyses are based on the EUROASPIRE IV survey, including CHD patients (18 to 80 years) who were hospitalized for a coronary event. These patients were interviewed and examined 6 months to 3 years after their hospitalization. Information on cardiovascular medication intake is available for 7953 patients.
About 99.2% of patients were on any kind of cardiovascular medication and 67.6% of patients were taking at least 5 different cardiovascular drugs. Overall, even when patients are taking the recommended drug combination as advised by the European guidelines - accounting for their disease profile - a large proportion of patients is still not on blood pressure, LDL-C or HbA1c target. In addition, huge variations were seen in medication dose intake across countries. Comparing the dose intake to the defined daily dose (DDD as published by the WHO) indicated a substantial deviation from the DDDs for a large proportion of patients.
This study provides a unique overview of the cardiovascular medication intake in CHD patients. Overall, even when patients are taking the advised drug combination, a large proportion of patients is still not on risk factor target. Physicians should seek for a balance in medication intake and appropriate dose, accounting both for the benefits and risks of chronic drug intake.
根据欧洲心血管预防指南的建议，药物治疗是二级预防的主要组成部分。本研究旨在深入了解稳定型欧洲冠心病（CHD）患者的药物治疗情况。
分析基于 EUROASPIRE IV 调查，包括因冠状动脉事件住院的 CHD 患者（18 至 80 岁）。这些患者在住院后 6 个月至 3 年内接受了访谈和检查。有 7953 名患者提供了心血管药物治疗信息。
约 99.2%的患者使用任何类型的心血管药物，67.6%的患者服用至少 5 种不同的心血管药物。总体而言，即使患者按照欧洲指南建议的适合其疾病特征的推荐药物组合进行治疗，仍有很大一部分患者的血压、LDL-C 或 HbA1c 目标未达到。此外，各国之间的药物剂量摄入存在巨大差异。与世界卫生组织（WHO）公布的定义日剂量（DDD）相比，相当一部分患者的药物剂量摄入与 DDD 有很大偏差。
本研究提供了 CHD 患者心血管药物治疗情况的独特概述。总体而言，即使患者接受了建议的药物联合治疗，仍有很大一部分患者的危险因素目标未达到。医生应在药物摄入和适当剂量之间寻求平衡，既要考虑慢性药物摄入的益处，也要考虑其风险。
