基于证据的治疗的采用与ST升高心肌梗塞患者的存活率之间的关联
Tomas Jernberg1, Per Johanson, Claes Held
1Department of Medicine, Section of Cardiology, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. tomas.jernberg@karolinska.se
JAMA
|April 28, 2011
概括
对ST升高心肌梗塞 (STEMI) 增加了基于证据的治疗方法的使用,与持续的死亡率降低有关. 这项研究强调了在真实世界医疗保健环境中采用新疗法对STEMI患者的积极影响.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于ST升高心肌梗塞 (STEMI) 新型基于证据的治疗方法的采用速度的数据有限.
- 在现实环境中,及时实施治疗与患者存活率之间的关联还不清楚.
研究的目的:
- 分析STEMI患者新治疗方法的采用趋势.
- 评估这些治疗变化对12年短期和长期生存的影响.
主要方法:
- 使用了关于瑞典心脏重症监护入院 (RIKS-HIA) 的瑞典信息和知识注册表.
- 包括61,238名在1996年至2007年期间被诊断患有STEMI的患者.
- 评估了随着时间的推移治疗比例和死亡率的变化.
主要成果:
- 观察到重灌疗法,初级穿皮冠状动脉干预和重血管化率的显著增加.
- 广泛采用药物,包括阿司匹林,克洛皮多格雷尔,β抑制剂,他类药物和ACE抑制剂.
- 住院,30天和1年死亡率的持续下降,在研究期间持续生存的好处.
结论:
- 该研究表明,从1996年到2007年,瑞典对STEMI的基于证据的治疗方法的实施明显增加.
- 这种增加的治疗方法与持续降低的死亡率相关,强调了在临床实践中遵守指南的重要性.
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