Antithrombotic and antiplatelet therapies in relation to risk stratification in patients with non-ST elevation acute coronary syndrome: insights from the Sino-Global Registry of Acute Coronary Events

摘要

Background Antithrombotic and antiplatelet therapies have been proposed to treat non-ST elevation acute coronary syndrome (NSTEACS), yet limited information is available about their applications from a multicenter "real-world" clinical procedure, especially in China. This study was undertaken to characterize the use of antithrombotic and antiplatelet agents in relation to the risk levels of the NSTEACS patients who were enrolled in Sino-Global Registry of Acute Coronary Events (GRACEs) registry study.Methods We analyzed the data from 618 Chinese NSTEACS patients stratified into low-(n=151), intermediate-(n=233), and high-risk groups (n=234) based on GRACE risk scores. The baseline characteristics, clinical presentations,antithrombotic and antiplatelet agents were recorded and compared among the three groups.Results The administration rates of low-molecular-weight heparins (LMWHs) (86.08%) and thienopyridines (85.92%)were higher whereas the administration rate of glycoprotein Ⅱb/Ⅲa inhibitor (1.78%) was much lower than those reported previously. Meanwhile, within the first 24 hours of admission, the use of heparin/LMWHs in the high-risk group was more than that in the intermediate-and low-risk groups (73.50% vs 63.09% vs 55.63%, P=0.001). Furthermore, the combination of antithrombotic and antiplatelet medications showed no significant differences in all groups.Conclusions In the "real world" practice of China, the antithrombotic and antiplatelet therapies on NSTEACS are well adherent to the current guidelines except for several gaps, such as the very low use of glycoprotein Ⅱb/Ⅲa inhibitor.Moreover, these antithrombotic and antiplatelet treatments usually tend to be underused for the high-risk ones.