越南老年人糖尿病和冠心病患者的衰弱状况及二级预防药物处方——一项观察性研究

Frailty and prescriptions of secondary prevention medications in older people with diabetes and coronary heart disease-An observational study in Vietnam.

作者信息

Wong Wei Jin, Nguyen Tan Van, Farooq Irum, Zhang Ying, Harrison Christopher, Tan Kit Mun, Harris Katie, Woodward Mark, Nguyen Tu

机构信息

Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Ho Chi Minh City Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

出版信息

Australas J Ageing. 2025 Jun;44(2):e70045. doi: 10.1111/ajag.70045.

Abstract

OBJECTIVES

This study sought to quantify the prevalence of frailty among type 2 diabetes (T2D) patients with coronary heart disease (CHD) and examine the relationship between frailty and the prescription of secondary prevention medications.

METHODS

A prospective observational study was conducted at a tertiary hospital in Vietnam from November 2022 to June 2023. Patients aged 60 years or above with T2D and CHD were included for analysis. Multivariable logistic regression was applied to examine the association between frailty and the prescription of secondary prevention medications: antiplatelets, statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEIs/ARBs). Frailty was measured using the Clinical Frailty Scale (CFS) version 2.0.

RESULTS

There were 274 participants included in this analysis. Participants had a median age of 72.0 years, 28% were female and 59% were frail. The prescription rates of cardiovascular medicines for frail versus non-frail participants were as follows: antiplatelets (66% vs. 94%, p < .001), statins (96% vs. 92%, p = .21), beta-blockers (81% vs. 88%, p = .13), ACEIs/ARBs (75% vs. 81%, p = .22) and for all four types (42% vs. 64%, p < .001). In the multiple adjusted regression models, increased CFS score was associated with reduced prescriptions of beta-blockers, ACEIs/ARBs and all four types of medications.

CONCLUSIONS

Frailty was common among older Vietnamese patients with CHD and diabetes, and significantly affected the prescription of secondary prevention medicines. Future research should explore the link between frailty and secondary prevention medicines in a larger, more diverse population.

摘要

目的

本研究旨在量化2型糖尿病(T2D)合并冠心病(CHD)患者中衰弱的患病率,并探讨衰弱与二级预防药物处方之间的关系。

方法

2022年11月至2023年6月在越南一家三级医院进行了一项前瞻性观察研究。纳入年龄在60岁及以上的T2D合并CHD患者进行分析。应用多变量逻辑回归分析衰弱与二级预防药物处方之间的关联:抗血小板药物、他汀类药物、β受体阻滞剂、血管紧张素转换酶抑制剂或血管紧张素II受体阻滞剂(ACEIs/ARBs)。使用临床衰弱量表(CFS)2.0版测量衰弱程度。

结果

本分析共纳入274名参与者。参与者的中位年龄为72.0岁,28%为女性,59%为衰弱患者。衰弱与非衰弱参与者的心血管药物处方率如下:抗血小板药物(66%对94%,p<0.001)、他汀类药物(96%对92%,p=0.21)、β受体阻滞剂(81%对88%,p=0.13)、ACEIs/ARBs(75%对81%,p=0.22)以及所有四种药物(42%对64%,p<0.001)。在多变量调整回归模型中,CFS评分升高与β受体阻滞剂、ACEIs/ARBs以及所有四种药物的处方减少相关。

结论

衰弱在越南老年CHD和糖尿病患者中很常见,并显著影响二级预防药物的处方。未来的研究应在更大、更多样化的人群中探索衰弱与二级预防药物之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25d9/12086956/d490987fb6d9/AJAG-44-0-g001.jpg

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