Marques-Vidal P, Cambou J P, Evans A, Arveiler D, Luc G, Bingham A, Cambien F
MONICA-Toulouse, INSERM U326 ORSMIP, C.H.U. Purpan, Toulouse, France.
Eur Heart J. 1995 Mar;16(3):348-53. doi: 10.1093/oxfordjournals.eurheartj.a060917.
As part of the ECTIM Study, the medical treatment given to male patients (25-64 years) 3 to 9 months after myocardial infarction (MI) were analysed in France and Northern Ireland. On univariate analysis, hypolipidaemic drugs, angiotensin-converting enzyme inhibitors and antiarrhythmic drugs were found to be prescribed more frequently in France, while beta-blockers were more common in Northern Ireland. No differences were found for diuretics, calcium channel blockers, antithrombotic and anti-anginal drugs, although the Northern Irish patients were mainly on antiplatelet drugs and nitrates, while the French patients received nitrates and non-nitrates, as well as oral anticoagulants and antiplatelet drugs in similar amounts. These differences remained after adjustment for personal history of diabetes, hyperlipidaemia, hypertension, and previous myocardial infarction, but the beta-blocker prescription was no longer significant. When the French centres were analysed, patients from Strasbourg were more frequently on oral anticoagulants and diuretics and less frequently on antiplatelet drugs, while patients from Toulouse had fewer anti-anginal drugs. Hence, although the current guidelines for secondary prevention of myocardial infarction are generally well applied in France and Northern Ireland, significant differences exist regarding the choice of the active drug.
作为ECTIM研究的一部分，对法国和北爱尔兰心肌梗死（MI）后3至9个月的男性患者（25 - 64岁）所接受的药物治疗进行了分析。单因素分析发现，法国更频繁地开具降血脂药物、血管紧张素转换酶抑制剂和抗心律失常药物，而北爱尔兰β受体阻滞剂更为常见。利尿剂、钙通道阻滞剂、抗血栓和抗心绞痛药物未发现差异，尽管北爱尔兰患者主要使用抗血小板药物和硝酸盐类药物，而法国患者接受硝酸盐类和非硝酸盐类药物，以及口服抗凝剂和抗血小板药物的比例相近。在对糖尿病、高脂血症、高血压和既往心肌梗死个人史进行调整后，这些差异仍然存在，但β受体阻滞剂的处方差异不再显著。对法国各中心进行分析时，斯特拉斯堡的患者更频繁地使用口服抗凝剂和利尿剂，抗血小板药物使用频率较低，而图卢兹的患者抗心绞痛药物较少。因此，尽管法国和北爱尔兰目前心肌梗死二级预防指南总体应用良好，但在活性药物的选择上存在显著差异。
