Brotons C, Calvo F, Cascant P, Ribera A, Moral I, Permanyer-Miralda G
Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Fam Pract. 1998 Oct;15(5):457-61. doi: 10.1093/fampra/15.5.457.
We aimed to evaluate the use of evidence-based prophylactic treatment after myocardial infarction on hospital discharge and in primary care after 1 year of hospitalization.
We conducted a 1-year prospective study of all the patients discharged from a tertiary hospital who had been treated for myocardial infarction from January 1 to December 31 1995. Three hundred and eighty surviving patients were consecutively discharged from the hospital. Seventy per cent of patients were treated with aspirin, 45% with beta-blockers, 27% with calcium channel blockers, 26% with ACE inhibitors, 40% with nitrates and 8% with cholesterol-lowering drugs after discharge from the hospital. In primary care, prescription of lipid-lowering drugs increased to 17%, while prescription of beta-blockers decreased to 34%. ACE inhibitor prescriptions at discharge were clearly more common in patients with impaired ventricular function or heart failure (57%).
According to the evidence, there is still potential for reducing the risk of a further ischaemic event or death in patients with MI, especially by increasing the use of beta-blockers and lipid-lowering drugs.
我们旨在评估心肌梗死后出院时及住院1年后在初级保健中基于证据的预防性治疗的使用情况。
我们对1995年1月1日至12月31日期间在一家三级医院接受心肌梗死治疗后出院的所有患者进行了为期1年的前瞻性研究。380名存活患者相继出院。出院后，70%的患者接受阿司匹林治疗，45%接受β受体阻滞剂治疗，27%接受钙通道阻滞剂治疗，26%接受ACE抑制剂治疗，40%接受硝酸盐治疗，8%接受降胆固醇药物治疗。在初级保健中，降血脂药物的处方率增至17%，而β受体阻滞剂的处方率降至34%。出院时ACE抑制剂的处方在心室功能受损或心力衰竭患者中明显更为常见（57%）。
根据现有证据，降低心肌梗死患者再次发生缺血性事件或死亡风险仍有潜力，特别是通过增加β受体阻滞剂和降血脂药物的使用。
