Wei Wang1, Dong Zhao2, Jun Liu2, Yue Qi2, Jiayi Sun2, Jing Liu2. 1. Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. Email: wangwei_8851@sina.com. 2. Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Abstract
OBJECTIVE: To analyze the distribution of multiple risk factors for hospitalized patients with acute coronary syndromes (ACS) and explore the status and determinants of drug usage recommended by the guideline. METHODS: This was a multi-center cross-sectional study in 34 hospitals from 22 provinces in China. About ninety ACS patients were consecutively enrolled from each hospital since April 15, 2012 according to a standard protocol. Totally, 3 253 patients with complete data were analyzed in this study. RESULTS: (1) The average age of male patients with ACS was lower than that of female patients (60.4 years vs 66.2 years, P < 0.01). Nearly 60% of ACS patients were under the age of 65 years. Early onset of ACS accounted for one-third of male (< 55 years of age) and two-fifthes of female patients (< 65 years old). (2) Among the four ACS major risk factors (hypertension, hyperlipidemia, smoking and diabetes), hypertension was with the highest prevalence (68.4%). More than 90% of ACS patients had at least one risk factor and about two-thirds of them had at least two. (3) As for the application of evidence-based drugs, the top one was aspirin with 95.3% of ACS patients reseiving it. The second was statins (90.1%). Angiotensin converting enzyme inhibitors (ACEI) or angiotension II receptor blocker (ARB) was the lowest (53.6%). Multivariable analysis indicated that, in contrast to that in ACS patients without percutaneous coronary intervention (PCI), the drug usage rates were increased by more than 30% for ACEI or ARB and β receptor blockers, by more than 50% for statins, and by 4-7 times for antiplatelet agents among ACS patients with PCI. CONCLUSIONS: In China, more than 90% of hospitalized patients with ACS carried at least one major risk factor. There is still room for improving in the application of drugs recommended by the guidelines, especially for ACS patients without PCI.
OBJECTIVE: To analyze the distribution of multiple risk factors for hospitalized patients with acute coronary syndromes (ACS) and explore the status and determinants of drug usage recommended by the guideline. METHODS: This was a multi-center cross-sectional study in 34 hospitals from 22 provinces in China. About ninety ACS patients were consecutively enrolled from each hospital since April 15, 2012 according to a standard protocol. Totally, 3 253 patients with complete data were analyzed in this study. RESULTS: (1) The average age of male patients with ACS was lower than that of female patients (60.4 years vs 66.2 years, P < 0.01). Nearly 60% of ACS patients were under the age of 65 years. Early onset of ACS accounted for one-third of male (< 55 years of age) and two-fifthes of female patients (< 65 years old). (2) Among the four ACS major risk factors (hypertension, hyperlipidemia, smoking and diabetes), hypertension was with the highest prevalence (68.4%). More than 90% of ACS patients had at least one risk factor and about two-thirds of them had at least two. (3) As for the application of evidence-based drugs, the top one was aspirin with 95.3% of ACS patients reseiving it. The second was statins (90.1%). Angiotensin converting enzyme inhibitors (ACEI) or angiotension II receptor blocker (ARB) was the lowest (53.6%). Multivariable analysis indicated that, in contrast to that in ACS patients without percutaneous coronary intervention (PCI), the drug usage rates were increased by more than 30% for ACEI or ARB and β receptor blockers, by more than 50% for statins, and by 4-7 times for antiplatelet agents among ACS patients with PCI. CONCLUSIONS: In China, more than 90% of hospitalized patients with ACS carried at least one major risk factor. There is still room for improving in the application of drugs recommended by the guidelines, especially for ACS patients without PCI.