PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■尽管有指南建议，在急性冠脉综合征患者中观察到血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB)的处方率均不理想.
■这项研究旨在检查时间趋势，变体,在马来西亚多种族人群中使用ACEI/ARBs的急性冠脉综合征患者和死亡率结局。
■这项回顾性研究利用了马来西亚国家心血管疾病-急性冠脉综合征注册的数据，涵盖2008年至2017年的连续患者记录（N=60,854）。检查了出院ACEI/ARBs处方的十年时间趋势。人口统计,比较了ACEI/ARBs处方和非处方患者的临床特征和1年全因死亡率结局.
■出院ACEI/ARB的10年处方率为52.8％（n=32,140），多年来大幅下降[线性趋势测试，P=0.008；SD=0.03；SE=0.001；95%CI=0.55-0.64]。年龄≥65岁（aOR=0.79；95％CI=0.73-0.86）的患者与年龄<65岁的患者相比，服用ACEI/ARBs的可能性较小。此外,合并糖尿病(DM)(aOR=0.85;95%CI=0.79~0.92)和慢性肾脏病(CKD)(aOR=0.34;95%CI=0.30~0.40)的患者接受ACEI/ARBs的可能性显著降低.IPW校正生存分析显示出院ACEI/ARBs处方患者1年全因死亡率降低38%(HR=0.62;95%CI=0.56-0.69;P<0.001)。
■在马来西亚，合并DM和CKD的急性冠脉综合征患者接受出院时ACEI/ARB的可能性较小。ACEI/ARB的次优处方率持续了10年，尽管服用ACEI/ARBs的ACS患者的1年生存率有所提高。
■这项研究旨在检查时间趋势，变体,在马来西亚多种族人群中使用ACEI/ARBs的急性冠脉综合征患者和死亡率结局。
■这项回顾性研究利用了马来西亚国家心血管疾病-急性冠脉综合征注册的数据，涵盖2008年至2017年的连续患者记录（N=60,854）。检查了出院ACEI/ARBs处方的十年时间趋势。人口统计,比较了ACEI/ARBs处方和非处方患者的临床特征和1年全因死亡率结局.
■出院ACEI/ARB的10年处方率为52.8％（n=32,140），多年来大幅下降[线性趋势测试，P=0.008；SD=0.03；SE=0.001；95%CI=0.55-0.64]。年龄≥65岁（aOR=0.79；95％CI=0.73-0.86）的患者与年龄<65岁的患者相比，服用ACEI/ARBs的可能性较小。此外,合并糖尿病(DM)(aOR=0.85;95%CI=0.79~0.92)和慢性肾脏病(CKD)(aOR=0.34;95%CI=0.30~0.40)的患者接受ACEI/ARBs的可能性显著降低.IPW校正生存分析显示出院ACEI/ARBs处方患者1年全因死亡率降低38%(HR=0.62;95%CI=0.56-0.69;P<0.001)。
■在马来西亚，合并DM和CKD的急性冠脉综合征患者接受出院时ACEI/ARB的可能性较小。ACEI/ARB的次优处方率持续了10年，尽管服用ACEI/ARBs的ACS患者的1年生存率有所提高。
