J Clin Lipidol:ASCVD的农村患者对他汀类药物的长期坚持率较高

2019-02-08 佚名 嘉音

在线发表于《Journal of Clinical Lipidology》杂志上的一样研究显示,在动脉粥样硬化风险高的患者中,他汀类药物的长期依从性并不理想,尽管全因死亡率较高,但患有ASCVD的农村患者对他汀类药物的长期坚持率明显高于城市患者。

在线发表于《Journal of Clinical Lipidology》杂志上的一样研究显示,在动脉粥样硬化风险高的患者中,他汀类药物的长期依从性并不理想,尽管全因死亡率较高,但患有ASCVD的农村患者对他汀类药物的长期坚持率明显高于城市患者。

全世界许多发达国家的农村和城市患者之间的血管健康存在明显的差异。相比于城市患者,农村患者的血管死亡率较高,并且获得以指南为基础的护理较差。这些患有ASCVD患者的最佳药物治疗中他汀类药物占有重要作用,因此患者服用该药的依从性对于获得实质性治疗益处至关重要。因此,澳大利亚墨尔本圣文森特医院心内科的Matthew R. Peverelle博士和团队进行了一项研究试图确定ASCVD患者长期坚持他汀类药物的比率,以及是否存在区域差异并预测依从性。

研究者们对2009~2013年期间在同一家三级中心接受冠状动脉造影的患者进行了随访。依从性定义为每周服用他汀类药物6天以上,并且根据澳大利亚标准地理分类,将患者居住的区域分类为RA1(主要城市),RA2(内部区域)和RA3(外部区域)。该研究对225例患者(69%男性,平均年龄64岁)进行了中位数为5.3年的随访。不同住居区域的患者的基线特征相似。所有患者的总体依从性为83%;然而,农村患者对他汀类药物治疗的依从性显著增加(主要城市组为80%,内部区域组为8%,外部区域组为93%,P=0.04)。 生活在外部区域患者中独立地预测他汀类药物的依从性高于主要城市区域(比值比:2.75,95% CI:1.1~7.8,P=0.03)。然而外部区域患者的全因死亡率显著高于其他区域(RA1为6%,RA2为12%,RA3为18%,P<0.01)。

研究结论指出尽管农村地区ASCVD患者全因死亡率较高,但农村ASCVD患者对他汀类药物的长期依从性显著高于城市患者。因此,其他因素如减少获得医疗保健和延迟诊断可能是导致农村和城市患者之间的结果差距的原因。

原始出处:
Peverelle MR, Baradi A, Paleri S. et al. Higher long-term adherence to statins in rural patients at high atherosclerotic risk. Journal of Clinical Lipidology. 2018 Nov 15.

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    2019-11-04 bettycmoon
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    2019-08-21 tongyongming
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    2019-08-29 quxin068
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    2019-02-10 doctorzheng
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    2019-02-10 daviiliu

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