在心肌梗塞后遵守二次预防治疗,有或没有阻塞性冠状动脉疾病
Anna M Nordenskjöld1, Miriam Qvarnström2, Björn Wettermark2
1Department of Cardiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
PloS one
|May 23, 2025
概括
患有非阻塞性冠状动脉心肌梗塞 (MINOCA) 的患者与患有阻塞性冠状动脉心肌梗塞 (MI-CAD) 的患者相比,对二次预防药物的坚持程度较低. 在MINOCA患者中,这种低于最佳的坚持可能会对他们的长期预后产生负面影响.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 在心肌梗塞 (MI) 后,二次预防药物对于减少心血管事件至关重要.
- 停用和不良服药是很常见的,影响患者的治疗结果.
- 有限的数据存在于药物坚持,特别是在非阻塞性冠状动脉 (MINOCA) 心肌梗塞患者.
研究的目的:
- 在被诊断为MINOCA的患者中,与那些患有冠状动脉阻塞性心肌梗塞 (MI-CAD) 的患者中,比较遵守指南推的二次预防药物.
主要方法:
- 在瑞典 (2006-2017年) 使用SWEDEHEART注册表进行了一项全国性的观察研究.
- 包括9,138名MINOCA患者和107,240名MI-CAD患者,平均跟踪时间为5.9年.
- 评估药物开始,实施 (药物持有率) 和随着时间的推移持续率.
主要成果:
- 与MI-CAD患者相比,MINOCA患者被处方二次预防药物的频率较低.
- 与MI-CAD患者相比,MINOCA患者在出院后的多个时间点中的阿司匹林,他类药物,ACEI / ARB和β-阻断剂的坚持率始终较低.
- 例如,在出院12个月后,在MINOCA中,阿司匹林的坚持率为84.4%,而在MI-CAD中为93.7%.
结论:
- 虽然在两组中,药物开始,实施和持续性通常都很高,但MINOCA患者的坚持率较低.
- 人们对MINOCA的遵守程度较低的潜在原因包括诊断的不确定性,患者的不同特征和心理社会因素.
- 在MINOCA患者中,低于最佳的坚持可能会导致不良预后结果,类似于在MI-CAD患者中观察到的效应.
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