Key result
In China between 1995-2015, pooled prevalence of post-MI medication use was 92% for aspirin, 72% for statins, and 63% for beta-blockers, with statin and beta-blocker use increasing significantly.
Why the study?
What is the prevalence and trend of guideline-recommended cardiovascular medication use for secondary prevention after myocardial infarction in China between 1995 and 2015?
Systematic Review (n=28,000)
What is the prevalence and trend of guideline-recommended cardiovascular medication use for secondary prevention after myocardial infarction in China between 1995 and 2015?
Despite significant increases in the use of beta-blockers and statins between 1995 and 2015, the utilization of guideline-recommended cardiovascular medications for secondary prevention after MI in China remains suboptimal.
Signals need to boost post-MI statin and beta-blocker use in China; extends trend data but leaves practice change to interventional trials.
BACKGROUND: Myocardial Infarction (MI) has become a major cause of morbidity and mortality in China, but little is known about the prevalence of guideline-recommended cardiovascular medications after MI events over the last two decades. This systematic review and meta-analysis aims to summarize cardiovascular medication use between 1995-2015 and to assess factors in associated with the trends in cardiovascular medications. METHOD: A systematic search was conducted in four databases (Pubmed, Embase, CENTRAL, and CNKI) to obtain observational studies published between 1995 and 2015, reporting on the use of cardiovascular medications in China. Risk of bias of individual studies was appraised and selected studies were pooled for estimated prevalence of cardiovascular medication. Prevalence of cardiovascular medication use for 1995 and 2015 was estimated by random effects meta-regression model. RESULTS: From 13,940 identified publications, 35 studies, comprising 28,000 patients, were included. The pooled prevalence for aspirin, beta-blockers, statins, ACE-Inhibitors, ACE-Inhibitor/ARBs and nitrates was 92% [95% confidence interval (CI): 0.89-0.95], 63% (95% CI: 0.57-0.69), 72% (95% CI: 0.60-0.82), 49% (95% CI: 0.41-0.57), 59% (95% CI: 0.48-0.69) and 79% (95% CI: 0.74-0.91), respectively. A significant increase in beta-blocker and statin use and a decrease of nitrate use was observed over time. The estimated prevalence of beta-blockers, statins, and nitrates was 78%, 91.1%, and 59.3% in 2015, compared to 32%, 17% and 96% in 1995, respectively. CONCLUSION: Cardiovascular medication use after MI is far from optimal in Chinese patients, even though the prevalence of use increased over the period 1995-2015. With a rapidly increasing number of MI patients in China, a comprehensive strategy on secondary prevention is warranted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42015025246).
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Zhao et al. (2017) conducted a systematic review in Myocardial Infarction (n=28,000). Cardiovascular medications was evaluated on Pooled prevalence of cardiovascular medication use. In China between 1995-2015, pooled prevalence of post-MI medication use was 92% for aspirin, 72% for statins, and 63% for beta-blockers, with statin and beta-blocker use increasing significantly.
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