中国卒中杂志2019，Vol.14Issue(7)：653-659,7.DOI:10.3969/j.issn.1673-5765.2019.07.005
缺血性脑血管病二级预防药物依从性与卒中复发的关系研究
Relationship between Secondary Prevention Medications Adherence and Recurrent Stroke in Patients with Acute Ischemic Cerebrovascular Events
摘要
Abstract
Objective To investigate the status of secondary prevention medications adherence in patients with ischemic cerebrovascular diseases in China, and the relationship between 3-month medication adherence and 1-year recurrent stroke after discharge in patients with acute ischemic stroke or TIA. Methods Patients diagnosed with first-ever acute ischemic stroke or TIA from Stroke and Transient Ischemic Stroke Treatment Adherence Registry in China were enrolled in this study. Medication adherence was defined as taking all secondary prevention medications prescribed at discharge continuously and regularly during the 3-month follow up. Multivariate logistic regression analysis was used to analyze the relationship between 3-month medications persistence and 1-year recurrent stroke after discharge. Results A total of 2768 patients were selected, with the mean age 62.3±11.4 years and 988 (35.7%) female patients. 2016 patients (72.8%) persisted in taking all secondary prevention medications during the 3-month follow up; the drug adherence rate were 95.3%, 90.9%, 90.2%, 85.4% and 73% for antiplatelet agents, blood glucose-lowering drugs, antihypertensive drugs, lipid-lowering drugs, and anticoagulation agents, respectively. The diabetes history (OR 1.40, 95% CI 1.14-1.73, P=0.0016) and the cessation history of blood glucose-lowering drugs might be the influence factors for drugs adherence, while there were no statistical significance after adjusting for the confounding factors. After adjusting for the confounders including age, sex, medical history and so on, logistic regression analysis showed 3-month persistence of secondary prevention medications was an independent influence factor for recurrent stroke at 1 year after discharge ( OR 0.36, 95% CI 0.14-0.91, P=0.0301). Conclusions The 3-month persistence of secondary prevention drugs was much more satisfactory compared to the previous results reported in Chinese patients. The 3-month persistence of secondary prevention medications was an independent influence factor for recurrent stroke at 1 year after discharge.关键词
依从性/二级预防药物/卒中复发/急性缺血性脑血管病Key words
Persistence/Secondary prevention medication/Recurrent stroke/Ischemic cerebrovascular disease引用本文复制引用
孟霞,张星,吕微,张心邈,荆京,谷鸿秋..缺血性脑血管病二级预防药物依从性与卒中复发的关系研究[J].中国卒中杂志,2019,14(7):653-659,7.基金项目
北京市属医院科研培育计划项目(PX2016052)国家自然科学基金-青年项目(81600999) （PX2016052）
