肾素-血管紧张素系统抑制剂的处方趋势与急性冠状动脉综合征患者的死亡率：来自马来西亚国家心血管疾病登记处的见解。

IF 1.3 Q2 MEDICINE, GENERAL & INTERNAL Saudi Journal of Medicine & Medical Sciences Pub Date : 2024-04-01 Epub Date: 2024-04-05 DOI:10.4103/sjmms.sjmms_422_23

Siti Zaleha Suki, Ahmad Syadi Mahmood Zuhdi, Abqariyah Yahya, Wan Ahmad Hafiz Wan Md Adnan, Nur Lisa Zaharan

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引用次数: 0

摘要

背景：尽管有指南建议，但在急性冠状动脉综合征患者中观察到的血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）处方率并不理想：本研究旨在探讨马来西亚多民族人口中急性冠状动脉综合征患者服用 ACEIs/ARBs 的时间趋势、变化和死亡率结果：这项回顾性研究利用了马来西亚国家心血管疾病-急性冠状动脉综合征登记处的数据，包括2008年至2017年的连续患者记录（N = 60,854）。研究考察了出院时开具 ACEIs/ARBs 的十年时间趋势。比较了开具和未开具 ACEIs/ARBs 处方的患者的人口统计学特征、临床特征和 1 年全因死亡率结果：出院时 ACEIs/ARBs 的 10 年处方率为 52.8%（n = 32,140），逐年显著下降[线性趋势检验，P = 0.008；SD = 0.03；SE = 0.001；95% CI = 0.55-0.64]。年龄≥65岁的患者（aOR = 0.79; 95% CI = 0.73-0.86）与年龄≥65岁的患者相比，更少可能被处方ACEIs/ARBs：结论：在马来西亚，同时患有糖尿病和慢性肾脏病的急性冠状动脉综合征患者在出院时接受 ACEIs/ARBs 治疗的可能性较低。尽管接受 ACEIs/ARBs 治疗的急性冠状动脉综合征患者的 1 年存活率有所提高，但 10 年间 ACEIs/ARBs 的处方率仍不理想。

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Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry.

Background: Despite guideline recommendations, suboptimal prescription rates of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been observed in patients with acute coronary syndrome.

Objective: This study aimed to examine the temporal trends, variations, and mortality outcomes among acute coronary syndrome patients prescribed ACEIs/ARBs in the multi-ethnic population of Malaysia.

Methodology: This retrospective study utilized data from the Malaysian National Cardiovascular Disease-Acute Coronary Syndrome registry, encompassing consecutive patient records from 2008 to 2017 (N = 60,854). Ten-year temporal trends of on-discharge ACEIs/ARBs prescription were examined. Demographics, clinical characteristics and 1-year all-cause mortality outcomes were compared between patients prescribed and not prescribed ACEIs/ARBs.

Results: The 10-year prescription rate of on-discharge ACEIs/ARBs was 52.8% (n = 32,140), with a significant decline over the years [linear trend test, P = 0.008; SD = 0.03; SE = 0.001; 95% CI = 0.55-0.64]. Patients aged ≥65 years (aOR = 0.79; 95% CI = 0.73-0.86) were less likely to be prescribed ACEIs/ARBs than those aged <65 years. In addition, patients with comorbid diabetes mellitus (DM) (aOR = 0.85; 95% CI = 0.79-0.92) and chronic kidney disease (CKD) (aOR = 0.34; 95% CI = 0.30-0.40) were significantly less likely to receive ACEIs/ARBs. IPW-adjusted survival analysis revealed a 38% lower 1-year all-cause mortality rate in patients prescribed on-discharge ACEIs/ARBs (HR = 0.62; 95% CI = 0.56-0.69; P < 0.001).

Conclusion: Acute coronary syndrome patients with concomitant DM and CKD were less likely to receive on-discharge ACEIs/ARBs in Malaysia. Suboptimal prescription rates of ACEIs/ARBs persisted over the 10-year period, despite improved 1-year survival in ACS patients prescribed ACEIs/ARBs.

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来源期刊

Saudi Journal of Medicine & Medical Sciences MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Saudi Journal of Medicine & Medical Sciences (SJMMS) is the official scientific journal of Imam Abdulrahman Bin Faisal University. It is an international peer-reviewed, general medical journal. The scope of the Journal is to publish research that will be of interest to health specialties both in academic and clinical practice. The Journal aims at disseminating high-powered research results with the objective of turning research into knowledge. It seeks to promote scholarly publishing in medicine and medical sciences. The Journal is published in print and online. The target readers of the Journal include all medical and health professionals in the health cluster such as in medicine, dentistry, nursing, applied medical sciences, clinical pharmacology, public health, etc.