Underuse of statins in patients with atherosclerotic ischemic stroke in China  

作　　者：LI Xi GAO Yan FENG Fang LIU Jia-min ZHANG Hai-bo ZHANG Dan HUNDEI Wu-han-bi-li-ge CHEN Fang CHEN Yi-ping CHEN Zheng-ming Martin Landray Jane Armitage JIANG Li-xin LI Li-ming 

机构地区：[1]Department of Epidemiology ＆ Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China [2]China Oxford Centre for International Health Research, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China [3]Clinical Trial Service Unit, Oxford University, Oxford, OX3 7LF, UK

出　　处：《Chinese Medical Journal》2012年第10期1703-1707,共5页中华医学杂志（英文版）

摘　　要：Background Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is recommended for patients at an increased cardiovascular risk. Survivors of a first ischemic stroke are at a risk of recurrence and of other vascular events and statins are generally recommended to reduce this risk. This study investigated how widely statins were being used for such patients in China. Methods Totally 6422 patients with a history of ischemic stroke were identified by reviewing medical records at 51 highest-ranking hospitals in 14 cities in China, and invited to attend a screening clinic to assess eligibility for a randomized trial. Their current statin and other drug uses were recorded alongside clinical and demographic characteristics. Univariate chi-square test and multivariate Logistic regression were used to determine the factors associated with treatment. Results Only 24% of these patients reported currently taking a statin. The most important predictor of statin use among these patients was prior history of coronary heart disease. History of diabetes or hypertension, as well as treated in university affiliated hospitals is related to increased use. The status had improved significantly during a 2-year period. Atorvastatin （40%） and simvastatin （39%） were the most commonly used. Conclusions In China, statins are still underused for secondary prevention among survivors of ischemic stroke. Reasons for this Door use need to be understood in order to increase use of these evidence based therapies.Background Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is recommended for patients at an increased cardiovascular risk. Survivors of a first ischemic stroke are at a risk of recurrence and of other vascular events and statins are generally recommended to reduce this risk. This study investigated how widely statins were being used for such patients in China. Methods Totally 6422 patients with a history of ischemic stroke were identified by reviewing medical records at 51 highest-ranking hospitals in 14 cities in China, and invited to attend a screening clinic to assess eligibility for a randomized trial. Their current statin and other drug uses were recorded alongside clinical and demographic characteristics. Univariate chi-square test and multivariate Logistic regression were used to determine the factors associated with treatment. Results Only 24% of these patients reported currently taking a statin. The most important predictor of statin use among these patients was prior history of coronary heart disease. History of diabetes or hypertension, as well as treated in university affiliated hospitals is related to increased use. The status had improved significantly during a 2-year period. Atorvastatin （40%） and simvastatin （39%） were the most commonly used. Conclusions In China, statins are still underused for secondary prevention among survivors of ischemic stroke. Reasons for this Door use need to be understood in order to increase use of these evidence based therapies.

关 键 词：hydroxymethylglutaryl-CoA reductase inhibitors ischemic stroke  secondary prevention 

分 类 号：Q513.5[生物学—生物化学] TQ464.4[化学工程—制药化工]