International variation in the use of evidence-based medicines for acute coronary syndromes

来自 EBSCO

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作者：

JM Kramer，Newby L.Kristin，Chang Wei-Ching，Simes R.John，Van de Werf Frans，CB Granger，KL Lee，HD White，LS Piegas，EJ Topol

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摘要：

AIMS: We sought to evaluate international patterns of use and factors influencing use of evidence-based medications early after .: Using a database of 15904 ACS patients enrolled in the SYMPHONY and 2nd SYMPHONY trials in 37 countries, we performed descriptive and logistic regression analyses. After controlling for other factors, region was significantly associated with the use of every class of evidence-based medication, most pronounced for intravenous unfractionated (IV UFH), low-molecular-weight (LMWH), II converting enzyme inhibitors () and discharge use of -lowering agents. Latin America and Eastern Europe were among the highest users of early , yet the lowest users of discharge -lowering therapy. Relative to the United States, all regions except Canada had greater use of LMWH and lower use of IV UFH. Compared with patients with , those with less often received aspirin, beta-blockers, , or IV UFH. Older age was associated with lower use of aspirin, beta-blockers, IV UFH, and -lowering agents.: Use of evidence-based therapies for management of patients is strongly associated with region. To improve patient outcomes, more research is needed to understand this variation, and to institute appropriate solutions.

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关键词：

Acute coronary syndromes Evidence-based medicine Drug therapy Cross-cultural comparisons International differences Guidelines

DOI：

10.1016/j.ehj.2003.09.018

被引量：

159

年份：

2003