冠心病二次预防的变化:INTERASPIRE研究
John William McEvoy1, Catriona Jennings1, Kornelia Kotseva1,2
1University of Galway School of Medicine and National Institute for Prevention and Cardiovascular Health, Moyola Lane, Newcastle, Galway H91 FF68, Ireland.
European heart journal
|August 30, 2024
概括
"INTERASPIRE"研究发现,对于冠心病 (CHD) 患者来说,二次预防和心脏康复指南的遵守是不充分的,并在全球范围内存在显著差异. 在实现治疗目标方面存在显著的地理和性别差异.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 冠心病 (CHD) 的管理依赖于二次预防和心脏康复,以减少死亡率和发病率.
- 国际指导标准存在,以优化患者住院后的结果.
- 及时实施这些标准至关重要,但在全球范围内评估往往具有挑战性.
研究的目的:
- 评估国际实施和遵守心脏病患者二次预防指南标准.
- 评估及时实现治疗目标,包括血压,LDL胆固醇和血糖控制.
- 根据地理和性别来确定护理中的差异.
主要方法:
- 在INTERASPIRE研究中,从2020年至2023年期间,在世卫组织所有6个区域的14个国家招募了4548名CHD患者.
- 参与者在住院后6-24个月接受了采访,并采集了标准化的数据.
- 年龄和性别标准化被用于国家一级的流行率估计.
主要成果:
- 只有38.6%的人达到目标血压 (<130/80 mmHg) 和16.6%的人达到目标LDL胆固醇 (<1.4 mmol/L).
- 已知糖尿病患者中有55.2%的人实现了血糖控制 (HbA1c <7.0%);9.8%的人没有检测到糖尿病.
- 心脏康复的出席率很低 (9.0%),只有1.0%符合最佳指南遵守标准;女性在关键指标上表现较差.
结论:
- 全球对心血管疾病二次预防指导方针的实施不足,且高度变化.
- 在实现推的治疗目标方面存在显著的地理和性别差异.
- 需要有针对性的投资来减少变化,并在全球范围内促进公平的二次预防.
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