中国华中地区冠心病和缺血性脑卒中二级预防抗血小板与他汀治疗现况调查

Status of secondary preventive antiplatelet and statin therapy for coronary heart disease and ischemic stroke in central China

目的:评估中国华中地区社区居民中既往患有冠心病和缺血性脑卒中人群的二级预防抗血小板和他汀治疗情况,分析个体特征与用药的关联关系。方法:本研究利用2015年9月—2019年11月中国华中地区3个省份心血管病高危人群早期筛查与综合干预项目采集数据,选取35~75岁常住居民,通过问卷调查收集患病及药物使用情况。采用多变量混合效应模型评估个体特征与二级预防用药的相关性。结果:在414209例调查对象中,自报患有冠心病、缺血性脑卒中史的比例为3.2%。在这些患者中,报告使用抗血小板药物、他汀类药物的比例为29.4%。多因素分析结果显示,女性、既往诊断心血管病>7年的调查对象使用抗血小板药物、他汀类药物的可能性更低。结论:中国华中地区冠心病和缺血性脑卒中患者人群目前二级预防用药情况不太理想。本研究明确了华中地区主要心血管病防控的靶点人群,便于制定针对性二级预防干预措施。

Objective:To explore the current use of secondary prevention antiplatelet and statin therapy among community residents with established coronary heart disease(CHD)and ischemic stroke(IS)in central China,and to identify its associated individual characteristics.Methods:his study was based on the data collected from the early screening and comprehensive intervention program for high-risk population of cardiovascular disease in 3 provinces in central China from September 2015 to November 2019.Permanent residents aged 35 to 75 were selected and their disease and drug use were collected through a questionnaire survey.Multivariable mixed models were fitted to assess the associations of individual characteristics with the reported use of secondary prevention therapies.Results:Among 414209 participants,3.2% reported a history of CHD and/or IS.Among these patients,29.4% reported using antiplatelet drugs and statins.Multivariate analysis showed that women and subjects with a prior diagnosis of cardiovascular disease>7 years were less likely to use antiplatelet drugs or statins.Conclusion:The current situation of secondary preventive drug use in patients with coronary heart disease and ischemic stroke in central China is not ideal.Our study identifies target populations,tailored interventions to improve secondary prevention of cardiovascular diseases.