| Objective To explore the related factors that affect the standard medication of patients with coronary heart disease implanted with DES one year after operation,and provide a reference for later improvement.Methods From July 2017 to January 2018,through the medical records room,there were869 patients with coronary heart disease who were implanted with DES in the Department of Cardiology,Ningxia Medical University General Hospital.Record general information of patients,including age,gender,weight,smoking,medical insurance,marital status;previous PCI,and whether they have hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia Clinical data.Whether to follow the doctor's order to take oral anti-platelet drugs,the type of drugs,the time of discontinuation,whether the adverse event and reactions to the drug were followed up in the patient by phone or outpatient clinic.Summarize the relevant factors that affect the standard medication of patients and the impact on patients after drug withdrawal.Results 1.There were 869 patients who met the selection criteria.During the period,60 patients were lost to follow-up.The rate of lost follow-up was 6.9%.A total of 809 patients were included in the later period.There were 745 cases(92.1%)in the standard medication group and 64 cases(7.9%)in the irregular medication group.4.In two groups,there was no statistically significant difference in age,gender,occupational status,BMI,smoking history,combined hypertension hyperlipidemia,hyperhomocysteinemia,type of disease,number of combined diseases,number of vascular lesions,type of medication and so on.According to the two-class Logistic regression analysis,the standard medication of patients was positively correlated with medical insurance(OR0.390,95% CI 0.162-0.938,P = 0.035)),marital status(OR 0.382,95% CI 0.174-0.837,P=0.016),previous PCI history(OR 0.503,95% CI 0.279-0.907,P=0.022).which was negative correlated with concomitant diabetes(OR 2.366,95% CI 1.178-4.752,P = 0.015).3.Among the discontinued,included 8 paitients who take aspirin alone(accounting for12.5%),included 5 who take clopidogrel or ticagrelor alone(accounting for 7.8%),and included 51 who stop take all medicines(accounting for 79.7%).Withdrawal time: about 19 patients who discontinued from discharge to June(accounting for 29.7%);about 45 patients who discontinued from June to 1 year(accounting for 70.3%).4.There were 64 patients who discontinued the drug.the main reason was not cooperate about 37 patients(accounting for 57.8%);the secondary reason for discontinuation was adverse reactions about 16 patients(accounting for 25.0%).;Other reason for discontinuation was did not explain clearly to patient about 9 cases(accounting for 14.1%);,and was combination with other diseases about 2 cases(accounting for 3.1%).5.Compared with the irregular medication group,standard medication group appear adverse event more lower,including the incidence of stent thrombosis(P = 0.000),non-fatal myocardial infarction infarction(P = 0.010),death(P = 0.006),and cerebral infarction(P =0.033).Conclusion 1.Postoperative coronary heart disease patients with medical insurance,spouse,and previous PCI history have good compliance;patients with diabetes have poor compliance.2.The main reason for discontinuation in the irregular medication group was the patient's non-cooperation,and the secondary reason was the occurrence of adverse reactions,the doctor's failure to explain clearly,and other diseases.And the withdrawal time is mainly concentrated in June to December.3.Patients with irregular medications have an increased risk of stent thrombosis,non-fatal myocardial infarction,cerebral infarction,and death. |
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