| 1 | 慢性口服抗凝药物对急性心肌梗死患者治疗和预后的影响:RICO调查资料显示文摘Objective: To determine the prevalence of chronic oral anticoagulant drug treatment(COA) among patients with acute myocardial infarction(AMI) and its impact on management and outcome. Methods: All patients with ST segment elevation AMI on the RICO(a French regional survey for AMI) database were included in this analysis. COA was defined as continuous use ≥48 hours before AMI. Results: Among the 2112 patients with ST elevation myocardial infarction(STEMI), 93(4%) patients were receiving COA. These patients were older and more likely to have a history of hypertension, diabetes and prior myocardial infarction than patients without COA. In addition, fewer patients who received COA underwent reperfusion therapy or received an antiplatelet agent(aspirin/thienopyridines). Moreover, patients receiving COA experienced a higher incidence of in-hospital major adverse events(death, recurrent myocardial infarction or major bleeding, p=0.005). Multivariate analysis showed that only ejection fraction, current smoking and multiple vessel disease, but not COA, were independent predictive factors for major adverse events. In contrast, COA was an independent predictive factor for heart failure when adjusted for age, diabetes, creatinine clearance, reperfusion, heparin and glycoprotein Ⅱb/Ⅲa inhibitors(odds ratio 2.06, CI 95%1.23 to 3.43, p=0,005). Conclusion: In this population based registry, patients with STEMI with prior use of COA constituted a fairly large group(4%) with an overall higher baseline risk profile than that of patients without COA. Fewer in the COA group received reperfusion therapy or aggressive antithrombotic treatment and they experienced more adverse in-hospital outcomes. Thus, further studies are warranted to develop specific management strategies for this high risk group. | Oudot A. Steg P.G. Danchin N. Y. Cottin 朱冰坡 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，，12： | 0 |
| 2 | REACH(减少动脉粥样硬化血栓形成保持健康)注册研究:针对易发生动脉粥样硬化血栓形成事件的危险人群的一项国际性、前瞻性观察研究显示文摘Background: The risk of atherothrombosis is a large health care burden worldwide. With its global prevalence, there is a need to understand all the associated risk factors, both old and new, and their interdependencies in the development of this complex disease leading to myocardial infarction, ischemic stroke, and vascular death and, thus, the major cause of mortality throughout the world. Methods: The REACH Registry sought to compile an international data set to extend our knowledge of atherothrombotic risk factors and ischemic events in the outpatient setting. The Registry will recruit approximately 68 000 outpatients in 44 countries across 6 major regions(Latin America, North America, Europe, Asia, the Middle East, and Australia) from >5000 physician outpatient practices. Patients aged ≥45 years with at least 3 atherothrombotic risk factors or documented cerebrovascular, coronary artery, or peripheral arterial disease will be enrolled. Medical history, risk factors, demographic information, and management will be collected at baseline, and clinical events that occur during the follow-up period of up to 2 years in duration will be recorded. Conclusion: The REACH Registry offers an opportunity to provide a better understanding of the prevalence and clinical consequences of atherothrombosis in the outpatient setting in a wide range of patients from different parts of the world. | Ohman E.M. Bhatt D.L. Steg P.G. 杜媛 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，2，9： | 0 |
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