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Clinicians' decisions to use and misuse long-acting nitrates in the management of acute coronary syndromes.

机译:临床医生决定使用和误用长效硝酸盐治疗急性冠脉综合征。

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摘要

Background. The correct application of organic nitrates for acute coronary syndromes (ACS) remains incompletely understood.; Objective. To examine long-acting (LA) nitrate use for ACS. Design. Postal survey.; Participants. Internists, cardiologists, and emergency physicians in Canada.; Measurements. Physicians' ratings of the decision to use LA-nitrates for 13 different ACS variables, and in three clinical vignettes.; Results. The response rate was 51.6%. Important determinants of LA-nitrate use were pulmonary edema, angina at rest with ECG changes, and ongoing rest pain. Nitrate use increased from 33% to 87% for the low and high-risk vignettes respectively. 34% of nitrate users selected a non-tolerance producing (intermittent) dosing regimen for the high-risk vignette. There were no differences in nitrate use or dosing regimen between specialists. Risk assessment was the most important predictor of LA-nitrate use by multivariable analysis.; Conclusions. LA-nitrates are frequently used for patients with ACS and many clinicians use intermittent dosing that maybe inappropriate.
机译:背景。有机硝酸盐在急性冠状动脉综合征(ACS)中的正确应用尚不完全清楚。目的。检查长效(LA)硝酸盐用于ACS的方法。设计。邮政调查。参加者加拿大的实习医生,心脏病专家和急诊医师。测量。医师对将LA-硝酸盐用于13种不同ACS变量以及在三种临床渐晕中使用的决定进行评级。结果。回应率为51.6%。硝酸亚硝酸盐使用的重要决定因素是肺水肿,静息心电图改变所致的心绞痛以及持续的休息疼痛。低风险和高风险小插图的硝酸盐使用率分别从33%增加到87%。 34%的硝酸盐使用者选择了高风险小插图的非耐受性(间歇性)给药方案。专家之间硝酸盐的使用或给药方案没有差异。通过多变量分析,风险评估是最重要的硝酸硝酸盐使用量预测指标。结论。 LA-硝酸盐经常用于ACS患者,许多临床医生使用可能不合适的间歇给药。

著录项

  • 作者

    Patel, Yashesh.;

  • 作者单位

    University of Toronto (Canada).;

  • 授予单位 University of Toronto (Canada).;
  • 学科 Health Sciences Medicine and Surgery.; Health Sciences Pharmacy.; Health Sciences Public Health.
  • 学位 M.Sc.
  • 年度 2006
  • 页码 81 p.
  • 总页数 81
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 药剂学;预防医学、卫生学;
  • 关键词

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