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巴西动脉粥样硬化血栓形成疾病登记研究(NEAT)的主要结果。

Primary results of the brazilian registry of atherothrombotic disease (NEAT).

机构信息

HCor Research Institute, 250 Abilio Soares Street, São Paulo, SP, 04.005-909, Brazil.

Brazilian Clinical Research Institute, São Paulo, Brazil.

出版信息

Sci Rep. 2024 Feb 20;14(1):4222. doi: 10.1038/s41598-024-54516-9.

Abstract

There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (± 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease.ClinicalTrials.gov NCT04677725.

摘要

在拉丁美洲,关于慢性动脉疾病患者的当代前瞻性真实世界证据有限。动脉粥样血栓形成控制网络(NEAT)登记处是一项针对巴西已知冠心病(CAD)和/或外周动脉疾病(PAD)患者的全国性前瞻性观察研究。该研究于 2020 年 9 月至 2022 年 3 月在 25 个地点共招募了 2005 名患者。收集了患者特征、药物和实验室数据。主要目的是评估在初始就诊时,符合动脉粥样血栓疾病心血管风险降低的良好医疗实践(领域)的患者比例。在总共纳入的 2005 名患者中,有 2 名因不符合入选标准而被排除在外。在纳入分析的 2003 名患者中,55.6%有孤立性 CAD,28.7%仅患有 PAD,15.7%同时患有这两种疾病。总体平均年龄为 66.3(±10.5)岁,65.7%为男性患者。关于循证治疗(EBTs),4%的患者未使用任何抗血栓药物,仅 1.5%的患者使用血管剂量利伐沙班(2.5mg bid)。只有 0.3%的患者满足二级预防的所有领域,包括 EBTs 的处方和体重指数、血压、LDL-胆固醇和生活方式建议的依从性的目标。EBTs 处方的主要障碍是医学判断。我们的研究结果表明,当代实践并未反映出综合的二级预防方法,而且在巴西,新疗法的应用率非常低。需要大规模的人群干预措施来解决这些差距,以提高循证治疗的应用率并降低动脉粥样血栓疾病的负担。ClinicalTrials.gov NCT04677725。

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