Department of Neurology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
Beijing Key Laboratory of Neurovascular disease discovery, Beijing, China.
BMC Neurol. 2024 Feb 15;24(1):64. doi: 10.1186/s12883-024-03564-9.
Vast economic and healthcare status discrepancies exist among regions in China, contributing to different treatment patterns. This study was aimed to investigate the current status of pharmacotherapy for acute ischemic stroke (AIS) and outcomes in China and explore the geographic variation in stroke care.
This study was a multicenter prospective registry study, which collected the data of patients with AIS from 80 hospitals in 46 cities in 2015-2017 across China. Poor functional outcome defined as a modified Rankin Scale score of 3-6 was assessed at 3 and 12 months. Multivariate logistic regression was used.
Among 9973 eligible patients, the number of receiving intravenous thrombolysis (IVT), antiplatelet agents, anticoagulants, statin and human urinary kallidinogenase was 429 (4.3%), 9363 (93.9%), 1063 (10.7%), 6828 (74.7%) and 5112 (51.2%), respectively. Multivariable analysis showed IVT use in northeastern was significantly more frequent than in eastern region (OR = 3.17, 95% CI, 2.53-3.99), while the antiplatelets agents use were less frequent (OR = 0.46, 95%CI: 0.38-0.57). The proportions of poor outcomes at 3 and 12 months were 20.7% and 15.8%, respectively. Multivariate analysis showed AIS patients from northeastern and central region had significantly lower risk of poor outcome at month 3 and 12 than those from eastern region (all P < 0.05).
There was a low IVT use and a high antiplatelet agent and statin use for AIS in China. The pharmacotherapy and prognosis of AIS had variation by geographic region.
This study was registered with ClinicalTrials.gov (NCT02470624).
中国各地区之间存在巨大的经济和医疗保健水平差异，导致治疗模式也存在差异。本研究旨在调查中国急性缺血性脑卒中（AIS）的药物治疗现状和结局，并探讨卒中治疗的地域差异。
这是一项多中心前瞻性注册研究，于 2015-2017 年期间从中国 46 个城市的 80 家医院共收集了 9973 例 AIS 患者的数据。在 3 个月和 12 个月时评估改良 Rankin 量表（mRS）评分 3-6 分的不良功能结局。采用多变量逻辑回归进行分析。
在 9973 例符合条件的患者中，接受静脉溶栓（IVT）、抗血小板药物、抗凝药物、他汀类药物和人尿激肽原酶的患者分别有 429（4.3%）、9363（93.9%）、1063（10.7%）、6828（74.7%）和 5112（51.2%）。多变量分析显示，东北地区 IVT 的使用率明显高于东部地区（OR=3.17，95%CI：2.53-3.99），而抗血小板药物的使用率较低（OR=0.46，95%CI：0.38-0.57）。3 个月和 12 个月时不良结局的比例分别为 20.7%和 15.8%。多变量分析显示，与东部地区相比，东北地区和中部地区的 AIS 患者在 3 个月和 12 个月时发生不良结局的风险明显较低（均 P<0.05）。
中国 AIS 患者的 IVT 使用率较低，抗血小板药物和他汀类药物使用率较高。AIS 的药物治疗和预后存在地域差异。
本研究在 ClinicalTrials.gov 注册（NCT02470624）。
