埃塞俄比亚梅克莱 Ayder 综合专科医院收治的急性冠脉综合征患者的治疗结果：一项回顾性横断面研究。
Treatment outcome of acute coronary syndrome patients admitted to Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia; A retrospective cross-sectional study.
机构信息
Clinical Pharmacy Unit, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
PLoS One. 2020 Feb 13;15(2):e0228953. doi: 10.1371/journal.pone.0228953. eCollection 2020.
BACKGROUND
Acute coronary syndrome (ACS) is increasingly becoming a common cause of cardiovascular mortality in developing countries. Even though, there is an introduction of limited percutaneous coronary intervention and thrombolytic therapies, in-hospital mortality due to ACS still remains high in sub-Saharan countries.
OBJECTIVE
The aim of the study was to assess treatment outcome of ACS patients admitted to Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia.
METHODS
A retrospective cross-sectional study was done by collecting data from patients' medical records using a data abstraction tool. Data were analyzed using logistic regression to determine crude and adjusted odds ratio. At 95% confidence interval, p-value<0.05 was considered as statistically significant.
RESULTS
Of the total 151 patients, in-hospital mortality was found to be 24.5%, and hypertension was the most frequent (46.4%) risk factor of ACS. Concerning the management practice, catheterization and primary percutaneous coronary intervention were done in 27.1%, and 3.9% respectively. Additionally, in emergency setting loading dose of aspirin and clopidogrel were used in about 63.8% and 62.8%, respectively. The other frequently used medications were beta-blockers (86.9%), angiotensin converting enzymes/angiotensin receptor blockers (84.1%) and statins (84.1%). Streptokinase was administered in 6.3% of patients with ST-elevated myocardial infarction and heparins in 78.1% of them. The commonly prescribed discharge medications were aspirin (98.2%), statins (94.7%) and clopidogrel (92%). Non-use of beta-blockers (p = 0.014), in-hospital complication of cardiogenic shock (p = 0.001) and left ventricular ejection fraction of ≤ 30% (p = 0.032) were independent predictors of in-hospital mortality.
CONCLUSION
The proportion of in-hospital mortality due to ACS was found to be high. Therefore, timely evidence based therapy should be implemented in the setup.
背景
急性冠状动脉综合征（ACS）在发展中国家日益成为心血管死亡率的常见原因。尽管已经引入了有限的经皮冠状动脉介入治疗和溶栓治疗，但撒哈拉以南国家的 ACS 院内死亡率仍然很高。
目的
本研究旨在评估入住埃塞俄比亚梅克莱 Ayder 综合专科医院的 ACS 患者的治疗结果。
方法
通过使用数据提取工具从患者病历中收集数据，进行回顾性横断面研究。使用逻辑回归分析数据，以确定粗比值比和调整比值比。在 95%置信区间内，p 值<0.05 被认为具有统计学意义。
结果
在总共 151 名患者中，院内死亡率为 24.5%，高血压是 ACS 最常见的（46.4%）危险因素。在管理实践方面，导管插入术和经皮冠状动脉介入术分别进行了 27.1%和 3.9%。此外，在紧急情况下，大约 63.8%和 62.8%的患者使用负荷剂量的阿司匹林和氯吡格雷。其他常用药物为β受体阻滞剂（86.9%）、血管紧张素转换酶/血管紧张素受体阻滞剂（84.1%）和他汀类药物（84.1%）。链激酶用于治疗 ST 段抬高型心肌梗死患者（6.3%），肝素用于治疗其中的 78.1%。常用的出院药物为阿司匹林（98.2%）、他汀类药物（94.7%）和氯吡格雷（92%）。未使用β受体阻滞剂（p=0.014）、院内心源性休克并发症（p=0.001）和左心室射血分数≤30%（p=0.032）是院内死亡的独立预测因素。
结论
ACS 导致的院内死亡率较高。因此，应在该环境中及时实施基于证据的治疗。
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