Trends in Early Aspirin Use Among Patients With Acute Myocardial Infarction in China, 2001–2011: The China PEACE‐Retrospective AMI Study

Abstract

BackgroundAspirin is an effective, safe, and inexpensive early treatment of acute myocardial infarction (AMI) with few barriers to administration, even in countries with limited healthcare resources. However, the rates and recent trends of aspirin use for the early treatment of AMI in China are unknown.Methods and ResultsUsing data from the China Patient‐centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction (China PEACE‐Retrospective AMI Study), we identified a cohort of 14 041 patients with AMI eligible for early aspirin therapy. Early use of aspirin for AMI increased over time (78.4% in 2001, 86.5% in 2006, and 90.0% in 2011). However, about 15% of hospitals had a rate of use of <80% in 2011. Treatment was less likely in patients who were older, presented with cardiogenic shock at admission, presented without chest discomfort, had a final diagnosis of non‐ST‐segment elevation acute myocardial infarction, or did not receive reperfusion therapy. Hospitalization in rural regions was also associated with aspirin underuse.ConclusionsDespite improvements in early use of aspirin for AMI in China, there remains marked variation in practice and opportunities for improvement that are concentrated in some hospitals and patient groups.Clinical Trial RegistrationURL: ClinicalTrials.gov Unique identifier: NCT01624883.

Appropriateness of antiplatelet therapy for primary and secondary cardio‐ and cerebrovascular prevention in acutely hospitalized older people

“…In the frame of secondary prevention, this study pointed out a large underprescription of antiplatelets in older people. This finding is consistent with other studies and may reflect concerns about the risk of bleeding. However, even if older people may be at high risk of adverse drug events, their risk for the adverse consequences of no treatment are likely to be substantially higher .…”

“…In the frame of secondary prevention, this study pointed out a large underprescription of antiplatelets in older people. This finding is consistent with other studies [37][38][39] and may reflect concerns about the risk of bleeding. However, even if older people may be at high risk of adverse drug events, their Table 3 Profiles of appropriateness of antiplatelet drug prescription in prescribed and non-prescribed patients according to primary and secondary prevention of cardiovascular disease risk for the adverse consequences of no treatment are likely to be substantially higher [2].…”

Secondary prevention of cardiovascular disease in China

“…6 In parallel with insurance reform, evidence-based guidelines for secondary prevention of IHD and stroke were published 7–9. Hospital-based studies suggest these developments have been accompanied by improvements in the treatment for secondary CVD prevention 10. However, community physicians lack awareness of the secondary prevention recommendations 11.…”

Ginkgolide C Alleviates Myocardial Ischemia/Reperfusion-Induced Inflammatory Injury via Inhibition of CD40-NF-κB Pathway

“…The activated complex goes on to phosphorylate IκB-α, causing its ubiquitin-mediated degradation and release of the NF-κB subunits ( Yang et al, 2017 ). And lots of evidence has shown that aspirin’s inhibitory effect of NF-κB has a close relationship with downregulation of IKK-β activity ( Gao et al, 2014 ). Then, we detected whether GC has the similar impact like aspirin on IKK-β activity.…”