BACKGROUNDLong-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.

METHODSIn 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.

RESULTSA 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).

CONCLUSIONSAlthough 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.

Acute Coronary Syndrome ; prevention & control ; China ; Coronary Disease ; prevention & control ; Humans ; Physicians ; statistics & numerical data ; Secondary Prevention ; methods ; Surveys and Questionnaires

BACKGROUNDDespite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy.

METHODSBetween June 2007 and October 2009, 16 860 patients aged 50 - 80 years with established history of atherosclerotic vascular disease (coronary heart disease (CHD), atherosclerotic cerebrovascular disease (CVD), or peripheral arterial disease (PAD)) from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics.

RESULTSAmong the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients (61% vs. 10% vs. 22% respectively) and decreased significantly with time from initial diagnosis. Simvastatin (mainly 20 mg) and atorvastatin (mainly 10 mg) each accounted for about 40% of total statin use.

CONCLUSIONSIn urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.

Aged ; Aged, 80 and over ; Atherosclerosis ; drug therapy ; Atorvastatin Calcium ; Cerebrovascular Disorders ; drug therapy ; Coronary Artery Disease ; drug therapy ; Cross-Sectional Studies ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Middle Aged ; Peripheral Vascular Diseases ; drug therapy ; Pyrroles ; therapeutic use ; Secondary Prevention ; methods ; Simvastatin ; therapeutic use