Background Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among ...Background Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy. Methods Between June 2007 and October 2009, 16 860 patients aged 50-80 years with established history of atherosclerotic vascular disease （coronary heart disease （CHD）, atherosclerotic cerebrovascular disease （CVD）, or peripheral arterial disease （PAD）） from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics. Results Among the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients （61% vs. 10% vs. 22% respectively） and decreased significantly with time from initial diagnosis. Simvastatin （mainly 20 mg） and atorvastatin （mainly 10 mg） each accounted for about 40% of total statin use. Conclusions In urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.展开更多
Background Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is re...Background Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is recommended for patients at an increased cardiovascular risk. Survivors of a first ischemic stroke are at a risk of recurrence and of other vascular events and statins are generally recommended to reduce this risk. This study investigated how widely statins were being used for such patients in China. Methods Totally 6422 patients with a history of ischemic stroke were identified by reviewing medical records at 51 highest-ranking hospitals in 14 cities in China, and invited to attend a screening clinic to assess eligibility for a randomized trial. Their current statin and other drug uses were recorded alongside clinical and demographic characteristics. Univariate chi-square test and multivariate Logistic regression were used to determine the factors associated with treatment. Results Only 24% of these patients reported currently taking a statin. The most important predictor of statin use among these patients was prior history of coronary heart disease. History of diabetes or hypertension, as well as treated in university affiliated hospitals is related to increased use. The status had improved significantly during a 2-year period. Atorvastatin （40%） and simvastatin （39%） were the most commonly used. Conclusions In China, statins are still underused for secondary prevention among survivors of ischemic stroke. Reasons for this Door use need to be understood in order to increase use of these evidence based therapies.展开更多
文摘Background Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy. Methods Between June 2007 and October 2009, 16 860 patients aged 50-80 years with established history of atherosclerotic vascular disease （coronary heart disease （CHD）, atherosclerotic cerebrovascular disease （CVD）, or peripheral arterial disease （PAD）） from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics. Results Among the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients （61% vs. 10% vs. 22% respectively） and decreased significantly with time from initial diagnosis. Simvastatin （mainly 20 mg） and atorvastatin （mainly 10 mg） each accounted for about 40% of total statin use. Conclusions In urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.
文摘Background Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is recommended for patients at an increased cardiovascular risk. Survivors of a first ischemic stroke are at a risk of recurrence and of other vascular events and statins are generally recommended to reduce this risk. This study investigated how widely statins were being used for such patients in China. Methods Totally 6422 patients with a history of ischemic stroke were identified by reviewing medical records at 51 highest-ranking hospitals in 14 cities in China, and invited to attend a screening clinic to assess eligibility for a randomized trial. Their current statin and other drug uses were recorded alongside clinical and demographic characteristics. Univariate chi-square test and multivariate Logistic regression were used to determine the factors associated with treatment. Results Only 24% of these patients reported currently taking a statin. The most important predictor of statin use among these patients was prior history of coronary heart disease. History of diabetes or hypertension, as well as treated in university affiliated hospitals is related to increased use. The status had improved significantly during a 2-year period. Atorvastatin （40%） and simvastatin （39%） were the most commonly used. Conclusions In China, statins are still underused for secondary prevention among survivors of ischemic stroke. Reasons for this Door use need to be understood in order to increase use of these evidence based therapies.
