National survey of doctor-reported secondary preventive treatment for patients with acute coronary syndrome in China.
Li J., Li X., Chen Y-P., Chen Z-M., Zhang L-H., Feng F., Zhang H-B., Liu J-M., Gao Y., Hundei W-B., Li L., Jiang L-X.
BACKGROUND: Long-term use of antiplatelet agents, statins, beta-blockers and angiotensin-converting enzyme inhibitors are proven therapies for secondary prevention in acute coronary syndrome. However, little is known of physicians' opinion about their use in China. METHODS: In 2010, standard questionnaires were posted to chief cardiologists in 1397 geographically diverse and representative sample of tertiary and secondary hospitals in China, collecting information about their opinions on the recommended treatments for acute coronary syndrome. RESULTS: A total of 1009 (72%) cardiologists responded with a valid questionnaire. Of them, 77% reported routine use of all the four main secondary preventive treatments, with little difference between secondary and tertiary hospitals (75% vs. 79%, P = 0.16). Of the cardiologists reporting routine or selective use of aspirin, beta-blockers, statins and angiotensin-converting enzyme inhibitors, 94%, 85%, 73% and 86% would recommend indefinite use respectively. For all the 4 treatments combined, only 63.5% reported indefinite use at the same time, with no significant difference between secondary and tertiary hospitals (62% vs. 65%, P = 0.17), nor between hospitals with or without fast track for primary percutaneous coronary intervention (66% vs. 61%, P = 0.50). CONCLUSIONS: Although Chinese cardiologists seem well informed about the value of main secondary preventive treatments for acute coronary syndrome, there is still gap in their understanding of the need for combined and prolonged use of these treatments.