在退伍军人人口中,低于最佳的药物占有率与复发性缺血性中风有关
Kyle C Kern1, Alexander Crossley2, Naomi Wu2
1Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Neurology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States.
概括
药物占有率 (MPR) 有效预测复发性中风风险. 通过干预措施改善药物坚持可以降低退伍军人中风复发率.
科学领域:
- 神经学 神经学
- 血管神经学 血管神经学
- 公共卫生 公共卫生
背景情况:
- 重复性中风显著增加了残疾和死亡率.
- 药物坚持对于二次中风预防至关重要.
- 药物占有率 (MPR) 提供了一个客观的衡量标准.
研究的目的:
- 评估MPR作为复发性中风风险的预测因素.
- 将MPR与传统的风险因素比较,例如弗雷明汉中风风险概况 (FSRP) 和中风病因.
- 为了确定改善中风患者药物坚持的干预措施.
主要方法:
- 对255名最近患有缺血性中风或TIA的患者进行了回顾性纵向队列研究.
- 计算了四个二次预防药物类别的平均MPR.
- 在5.0年的中位数随访期间,追踪了复发性中风事件.
主要成果:
- 较低的平均MPR四分位数与更高的复发性中风发病率显著相关 (SHR1.63,p<0.001).
- 在考虑竞争性风险和FSRP之后,MPR仍然是一个重要的预测指标.
- 较高的基线缩血压 (≥132 mm Hg) 也独立地与复发有关.
结论:
- MPR是评估个性化复发性中风风险的宝贵工具.
- 系统级和个性化干预措施是必要的,以提高药物坚持.
- 在VA人群中减少复发性中风率需要改进的坚持策略.
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