天津市新发急性冠脉综合征患者抗血小板用药依从性与持续性分析

目的:评估天津市新发急性冠脉综合征(ACS)患者二级预防期间抗血小板药物的依从性与持续性,并探究其影响因素.方法:使用天津市城镇职工基本医疗保险参保人30％随机抽样数据库,纳入2012年1月1日至2014年12月31日期间有过≥1次以ACS为主要出院诊断(ICD-10:I20.0,I21,I22),出院后30 d内有≥...

Adherence and Persistence with Antiplatelet Agents in Patients with New EpisodeP of Acute Coronary Syndrome in Tianjin

Objective:To investigate the adherence and persistence with antiplatelet agents and their associated factors among patients with new episode of acute coronary syndromes(ACS)in Tianjin,China.Methods:Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database.Adult patients who initiated with antiplatelet agents between January,2012 to December,2014,which occurred within a 30-day time window after discharge from the first hospitalization for ACS(index hospitalization)were included.Patients who had major adverse cardiovascular events(MACE)within the initial 30 days follow-up were further excluded.Adherence and persistence of antiplatelet agents were analyzed during the 12-month follow-up period and their associated factors were also investigated,respectively.Results:5486 patients(63.15±10.81 years;60.23%male)were identified.Only 10.9%of them were adherent to antiplatelet agents during follow-up,and the mean proportion of days covered(PDC)was 39.17%±29.25%among the total cohort.90.08%of patients discontinued antiplatelet agents and the average time to discontinuation was 103.89±110.27 days.Male,patients who received percutaneous coronary intervention(PCI)and patients who had longer stay during index hospitalization had better adherence and persistence.Furthermore,patients utilized calcium channel blockers(CCB)during baseline period were more likely to be adherent,while patients who prior usedβ-blockers had poorer persistence.Conclusion:Adherence and persistence to antiplatelet agents were unsatisfactory among the patients with new episode of ACS in Tianjin.Male,receiving PCI and longer stay during index hospitalization were associated with better adherence/persistence.