傳媒發布會 Press Conference19/11/2013

關心您的心冠心病及其療法認知調查SURVEY ON KNOWLEDGE OF CORONARY HEART DISEASE AND TREATMENTS

發布會內容CONTENT• 研究背景及目的

Research background & objectives

• 調查方法Research methodology

• 調查結果及分析Research findings & analysis

• 有關冠心病及其療法簡介 About Coronary Heart Disease & its treatment methods

• 個案分享及總結Case Sharing & Conclusion

• 「關心您的心」近期活動Care For Your Heart upcoming activities

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研究背景及目的RESEARCH BACKGROUND & OBJECTIVES

「關心您的心」介紹About CARE FOR YOUR HEART

• 成立於一九九五年十一月，是首個由患有各類心臟病患者及家屬組成的社區互助組織Founded in 1995, Care For Your Heart is the first community-based cardiac patients self-help association

• 得到榮譽贊助人梁唐青儀女士的鼎力支持並由各界專業人士，包括心臟專科醫生、營養師、物理治療師、社會工作者、護士及職業治療師等擔任名譽顧問The association has been supported by Mrs. Regina Leung as Patron of the association and a board of Honorary Advisers from various specialties, including cardiologists, dietitians, pharmacists, social workers, nurses, therapists and other professionals

• 本會致力為病友及市民大眾提供全面心臟健康及復康服務The association is committed to provide comprehensive heart health and rehabilitation service to patients and public

• 服務宗旨為發揮會友及家屬互助互勉精神，解開因病帶來的困惑和恐懼。攜手共進復康之路，邁向豐盛人生。To promote mutual support and self-help among cardiac patients and family members for betterment in heart health and well being of life

• 本會的服務範圍包括舉辦心臟復康活動、病友互助小組及分享聚會、病友關懷服務、心臟健康推廣活動、心臟資料製作及權益爭取及倡導。Our services include cardiac rehabilitation service, patients mutual support groups and caring service, telephone counseling, public heart health promotion, production of education materials and advocacy

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研究背景及目的 Research Background & Objectives

• 心臟病是香港第三號殺手。在各種心臟病當中，冠心病是引致心臟病死亡的主因，佔68.9%*Heart disease is the 3rd highest cause of death in Hong Kong and Coronary Heart Disease (CHD) makes up 68.9%* of heart diseases deaths

• 現時冠心病療法當中，進行「通波仔」植入心臟支架為香港最常見的療法PCI stenting is a common treatment for CHD

• 而在「通波仔」支架選擇上，亦該因應病人不同的身體情況而作出不同的選擇Patients should talk with their doctors to choose the most suitable stents according to the different patient conditions

• 有見及此， 心臟病人互助組織「關心您的心」進行香港冠心病患者對「通波仔」療法的認知調查，旨在了解本港冠心病患者對「通波仔」療法選擇及其服藥療程的認知，亦藉此增進市民對療法選擇的了解Care For Your Heart, the cardiac patients mutual support association, conducted a knowledge survey of PCI treatment options and associated medication among CHD patients in Hong Kong, with the objective of enhancing understanding of the treatment among the community and the general public

* 香港衛生署 2011 年統計數據（ 2011 Data, Department of Health ）

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調查方法 RESEARCH METHODOLOGY

調查方法Research Methodology

• 調查日期 (Interview period) ：

2013 年 7 月 15 日 – 2013 年 8 月 2 日 July 15 – Aug 2, 2013

• 訪問對象 (Target sample) ：

「關心您的心」病友 （曾進行通波仔手術的冠心病病人） Members of Care For Your Heart (Patients who had undertaken PCI)

• 調查方法 (Methodology) :

由「關心您的心」訪問員對該病友組織的患者進行電話訪問Interviewers of Care For Your Heart to conduct telephone interview with the members of the association

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• 問卷主要研究以下部份 (The questionnaire mainly looks into the following parts) ：

▫ 對「通波仔」療法植入支架種類的認知The knowledge about different types of stents

▫ 對進行「通波仔」後服藥療程的認知The knowledge about medication after PCI

▫ 對常規心臟健康檢查重視程度The awareness of the importance of regular heart health test

▫ 冠心病患者獲取療法資訊的途徑The information channels of CHD for patients

• 樣本數目 (Sample size) ： 215 個成功個案 (215 successful cases)

• 有效回應比率 (Respond rate): 87.8%

調查方法Research Methodology

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• 受訪者年齡介乎 36 歲至 89 歲之間，大多數（ 67.4% ）受訪者介乎 61歲至 80 歲；樣本中男性佔七成五The sample population was aged between 34-89 and the majority (67.7%) aged between 61-80. About 75% of respondents were male

樣本年齡及性別分布Distribution of Sample by Age Group and Gender

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研究結果及分析RESEARCH FINDINGS & ANALYSIS

逾三成半受訪者在過去一個月沒有接觸有關心臟病的資訊Over 35% of respondents had not came into contact with information about heart disease over the past month

對心臟健康的注意程度Awareness of Heart Health

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過半數受訪者十分樂意了解更多關於冠心病資訊Over 50% of respondents are interested in reading information related to PCI

對心臟健康的注意程度Awareness of Heart Health

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心臟病療法及護理資訊來源Source of Getting Treatments Information

超過六成受訪者表示通過健康講座或小冊子瞭解心臟病療法Over 60% of respondents indicated that health talks, leaflets and booklets were the main source of getting information about treatments of heart disease

仍有超過一成六受訪者認為坊間有關心臟病療法的資料不足夠There is still 16% of respondents expressed that there is not enough information about heart disease treatments out there

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接近三成受訪者未能講出任何一種支架類型Almost 30% of respondents could not name any one type of stent

僅一成七受訪者能答中三種以上支架Only 17.7% of respondents were able to name 3 or more types of stent

現時香港共有五種支架可供選擇 - 裸金屬支架、藥物塗層支架、生物工程支架、全吸收式生物血管模架及最新推出的雙療法支架There are 5 types of stent available for PCI in Hong Kong – Bare Metal Stent, Drug Eluting Stent, Bio-engineered Stent, Bioresorbable Vascular Scaffold and the latest Dual Therapy Stent

對支架的認識Knowledge on Stent Options

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接近兩成受訪者不清楚自己血管內所植入的支架類型18% of respondents did not know the type of stents that has been implanted in their vessels

超過一半受訪者植入了藥物塗層支架More than half of the respondents were implanted with Drug Eluting Stent

植入支架類型Stent Implanted

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接近八成受訪者聽從醫生建議選擇支架類型78% of respondents followed doctor’s recommendations when selecting stents

僅約一成受訪者以支架療效作為選擇準則Only 10% of the respondents chose the stent because of its efficacy

選擇支架準則Criteria when Selecting Stent

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即使接近八成受訪者聽從醫生建議選擇支架，仍有約四成認為在術前沒有得到足夠有關支架的資訊，但同時超過一半受訪者表示從未向醫生主動了解Although almost 80% of respondents depended on doctors when choosing stent, still about 40% believed that they did not receive enough information from their doctors; however, over 50% did not actively seek for stent information from their doctors

若對支架選擇存有疑問或認知不足，我們鼓勵病人應多發問，及主動向醫生了解Patients are encouraged to asked more if they do not understand about the stent options

了解心臟支架種類的主動性Intention to Know More about Stents

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逾半受訪者知道植入不同類型支架，醫生所建議的服藥時期會有所不同。 但仍有四成七受訪者表示不知道More than half of the respondents realized that the medication treatment period varies between stents, but still there is 47% of them did not know about this

一般來說， 不帶藥及有抗體塗層的支架服藥期較短， 植入藥物塗層支架則需長期 ( 不少於12 個月 ) 服用雙重抗血小板藥物。而植入雙療法支架，根據研究指引需服藥 6 個月In general, medication treatment after implanting stents without drug or with antibody-coating would be shorter. With Drug Eluting Stents, patients would be required to take longer period (not less than 12 months) of dual antiplatelet therapy. And for Dual Therapy Stent, according to study’s protocol, 6 months medication is recommended

支架及所配合藥物療程的認知Knowledge of Stents and Its Medical Treatment

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超過九成受訪者於術後需服用雙重抗血小板藥物 12 個月或以上，逾半更需要永久服用Over 90% of respondents has been instructed to take DAPT for 12 months or more, more than 50% need to take DAPT for life

雙重抗血小板藥物的作用為減低血塊形成的機會，降低血管栓塞的風險The use of DAPT is for preventing the formation of blood clots in order to reduce the risk of thrombosis

長期服用雙重抗血小板藥物有機會增加出血風險， 服藥期間要動其它手術而需要停藥的病人，血管栓塞的風險亦會增加Long-term DAPT might increase the risk of bleeding. For patients who need to stop the medication due to near-term surgery, risk of thrombosis will also increase

服藥時間Period of Medication

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有近三成受訪者表示曾經忘記服用雙重抗血小板藥物29% of respondents have experienced forgetting to take prescribed medicine DAPT on time after undergoing PCI

服藥依從性Medication Compliance

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約半成受訪者表示曾經因要進行手術以停藥，兩成三則根據醫生指示暫停或停止服用About 5% of the respondents indicated that they had to terminate the medication due to surgery. 23% was instructed to suspend or terminate the medication by their doctors

而逾七成半受訪者於未有醫生指示下自行停藥，當中原因以忘記服用為最多 (66%) ，亦有人表示因不知道是否需要，或認為不需要而決定暫停或停止服用雙重抗血小板藥物More than 75% of the respondents had stopped taking DAPT without doctor’s instruction, most of them (66%) said they have forgotten to. Some of them expressed that they suspended or terminated due to the uncertainty of the need for the medication or felt that there was no need to take the medication

需要停藥的情況Termination of Medication

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超過六成受訪者表示醫生於手術後有告訴他們於服藥期間如需進行其它手術或有出血情況出現應該怎麼做More than 60% of respondents said that doctors had told them what they should do if they need to undertake other surgery or bleeding occurred during the medication period

建議市民如有需要進行「通波仔」，應主動瞭解多一點有關服藥的資訊， 以及自己的身體狀況是否適合長期服用抗血小板藥物。It is suggested that patients should take the initiative to acquire more information about the medication, and to learn if their own condition is suitable for long-term DAPT

醫生所提供有關藥物的資訊DAPT Information from Doctors

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大部份受訪者均表示即示身體狀況好轉 (87%) 或感到不適 (83%) 亦不會自行停藥Most of the respondents indicated that they would not stop taking DAPT even if they feel better (87%) or experience side effect symptoms (83%)

但仍有逾一成表示即使醫生沒有許可， 仍會自行停藥However, there was still more than 10% of the respondents expressed that they would stop taking DAPT without doctor’s permission

服藥依從性Medication Compliance

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逾半數受訪者均能講出植入心臟支架後沒有按時服藥的最大風險 - 血塊形成及血栓More than half of the respondents were able to identify the largest risk of not taking DAPT on time - Blood Clot Formation and Thrombosis

僅 4 人 (1.9%) 意識到擅自停藥或會導致死亡Only 4 respondents (1.9%) mentioned that it may lead to death

仍有逾三成半受訪者未能講出任何有可能出現的風險There were still 37% could not identify any one of the possible risks

不依時服藥風險的認知Knowledge of Associated Risks of Medication Non-compliance

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有關冠心病及其療法簡介ABOUT CORONARY HEART DISEASE & ITS TREATMENT METHODS

冠心病簡介About Coronary Heart Disease

冠狀動脈心臟病」簡稱冠心病，是指環繞心臟的冠狀動脈因脂肪及膽固醇積聚而變得狹窄或閉塞。病人會因此血液流動不良，導致心肌缺氧，嚴重的甚至會引致心肌壞死，令患者心跳停頓而突然猝死

Coronary Heart Disease (CHD) refers to the narrowing and obstruction of arteries supplying blood to the heart through progressive accumulation of fat and cholesterol which leads to poor blood circulation, myocardial anoxia and even causes myocardial necrosis. In the worst case scenario, patients may die due to sudden cardiac arrest, or more commonly known as heart attack

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冠心病主要成因The causes of CHD include

• 膽固醇過高 (Excess cholesterol level)• 吸煙 (Smoking)• 過胖 (Excess fat)• 糖尿病 (Diabetes)• 高血壓 (Hypertension)• 生活緊張，壓力過大 (Stressful lifestyle under high pressure)• 缺乏運動 (Lack of exercise)• 家族遺傳 (Family history)

冠心病簡介About Coronary Heart Disease

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冠心病目前的治療方法 Current treatments for CHD include

• 藥物治療 Drug Treatment

• 冠狀動脈介入手術 , 俗稱「通波仔」Percutaneous Coronary Intervention (PCI)

• 冠狀動脈搭橋手術 Coronary Artery Bypass Graft Surgery

冠心病簡介About Coronary Heart Disease

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有關冠心病及其療法簡介About Coronary Heart Disease & Its Treatment Methods

1. 一個帶球囊的導管穿過血管狹窄處Balloon catheter is advanced through the site of arterial stenosis

2. 導管前端的球囊擴張，擴開血管狹窄處Balloon catheter is dilated at lesion site to open up channel for blood circulation

3. 球囊回縮變小並撤出The balloon catheter is deflated and withdrawn

4. 帶有支架的導管再次進入狹窄處，球囊導管擴張，支架同時被撐開釋放Stent pre-mounted on balloon catheter is then delivered to lesion site and deployed

5. 球囊回縮變小撤出，支架將永久置入血管內Balloon catheter is withdrawn and the stent remains in the artery permanently

冠狀動脈介入手術 , 俗稱「通波仔」過程 簡介 The simple steps of PCI stenting

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一般情況下， 如冠狀動脈狹窄的情況不太嚴重，可以使用藥物控制病情。不過， 當血管收窄 60%-70% 以上， 便要考慮進行冠狀動脈介入治療術， 將冠狀動脈支架植入， 支撐著血管。同一樣的支架並非完全適用於每位病人，醫生需視乎病人的情況而選擇使用哪一類型支架。如血管病變程度、禁忌症和經濟狀況等In general, if coronary stenosis is not severe (<50%), medication treatment might be advised to control the disease. However, with arterial blockage in excess of 60% to 70%, Percutaneous Coronary Intervention (PCI) would probably be recommended and the procedure often involves the implantation of coronary stent(s) to provide scaffolding to keep the coronary artery open permanently. In general, stent selection depends primarily on patients’ baseline characteristics; lesion type, contra-indications and patients’ financial situation may also be factors for consideration

認識冠狀動脈支架 Coronary Stents

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金屬網格管狀支架用於通波仔手術後用以永久支撐血管A metal mesh tube used to provide permanent scaffolding to keep coronary arteries open, usually following a balloon angioplasty

不同類型支架都具有其獨特的屬性、優點和缺點Various stent types with each having its distinctive properties as well as advantages and disadvantages

認識冠狀動脈支架 Coronary Stents

現時支架大致可分五類：There are currently 5 types of

stents available in the market: 裸金屬支架 (Bare Metal Stent) 單療法支架 (Mono-therapy Stent)

藥物塗層支架 (Drug Eluting Stent)

生物工程支架 (Bio-engineered Stent)

全吸收式生物血管模架 (Bioresorbable Vascular Scaffold)

雙療法支架 (Dual Therapy Stent)

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裸金屬支架Bare Metal

Stent

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裸金屬支架 (BMS)性質 Properties•純金屬支架，植入心血管後能將血管阻塞的地方張開，令血液能再次暢通運行A plain metallic scaffolding without any coating that can immediately widen the blockage area (lesion) within the blood vessel after implantation to facilitate regular blood flow

強項 Advantages•費用較其他種類的支架便宜；而手術後一般只需服用一個月雙重抗血小板藥物（如 : 柏域斯及阿士匹靈）Costs are relatively cheap. After implantation, patient will need to take one to twelve months dual anti-platelet therapy (i.e. Plavix and aspirin)

弱項 Disadvantages•因血管內壁的細胞過度增生而導致心血管再次收窄的機率相對較高A relatively higher chance of vessel re-narrowing or restenosis as a result of hyperplasia caused by vessel trauma during stent implantation

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單療法支架Mono-therapy

Stent

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性質 Properties•備有藥物塗層的金屬支架，藥物會慢慢滲透入血管壁，減少細胞增生，防止血管再度收窄An anti-proliferative drug is embedded in a polymer coated on the stent’s surface and is gradually released and absorbed through the vessel, reducing cell proliferation or hyperplasia, preventing re- narrowing of the vessel

強項 Advantages•減低心血管再次收窄機會Effectively reduce the chances of In- Stent Restenosis (Re- narrowing)

弱項 Disadvantages•手術後因抑制了內皮祖細胞的增長，有礙血管癒合，增加支架位置形成血栓的機會，故需長期（不少於 12 個月）服用雙重抗血小板藥物Anti-proliferative drug inhibits the growth of endothelial progenitor cells, delaying the natural healing process and increasing the chance of stent thrombosis. Recommended dual anti-platelet therapy (DAPT) is a minimum of 12 months

藥物塗層支架 (DES)

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全吸收式生物血管模架 (BVS)性質 Properties•塗有藥物的可溶性模架會隨著時間分解然後被人體自然吸收A new type of drug coated stent platform which could naturally be absorbed and metabolized by the body in time, leaving no permanent implant in blood vessels

強項 Advantages•能抑制血管壁細胞增生的藥物塗在可分解性塑膠物料而製的模架上，減低血管再次收窄機會，而模架則在植入血管兩年後消失 Coated with an anti-proliferative drug to minimize re-narrowing and the biodegradable scaffold will be dissolved after two years

弱項 Disadvantages•由於這種模架的獨特物料結構的關係，如患有血管嚴重鈣化，迂曲或分叉病變等之病人可能不適用Due to scaffold material, may not be suitable in patients with calcified, tortuous and bifurcation lesions

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據歐洲心臟病醫學會 /歐洲心胸外科學會指引不適宜使用藥物塗層支架的病人ESC/EACTS Guidelines on Contraindications to DES

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性質 Properties•支架內壁塗有抗體，吸附血液中的內皮祖細胞成為內皮層覆蓋支架表面，加快血管自然修復過程，降低血栓及血管再收窄的機會Stent is coated with antibodies that rapidly capture circulating endothelial progenitor cells in the blood stream, accelerating the natural healing process (endothelization) and reducing the chance of stent thrombosis and vessel re-narrowing

強項 Advantages•加快血管壁自然修復過程，因此能減低晚期血栓及心血管再收窄的機率。醫生一般建議手術後只需服用雙重抗血小板藥物一個月Accelerated natural healing process reduces chance of late stent thrombosis and vessel re-narrowing. Recommend DAPT of one month after stent implantation

生物工程支架

弱項 Disadvantages•生物工程支架是一個自然癒合過程，它沒有殺死細胞的藥物塗層，因此第一年再收窄的機會略高於藥物塗層支架Absence of an anti-proliferative drug to suppress cell proliferation, resulting in a higher chance of vessel re- narrowing within the first year

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* Iakovou, I. et al. JAMA 2005;293:2126-2130

再狹窄 v.s. 血栓 Restenosis vs.Thrombosis

（有效性 與 安全性） (Efficacy vs. Safety)

再狹窄 Restenosis先前經通波仔治療過的血管再狹窄或再出現阻塞Re-narrowing or blockage of a previously-treated artery by coronary angioplasty

血栓 Thrombosis在血管成植入支架範圍出現或形成血塊Presence or formation of blood clots in a vessel or on stented area

一般血栓形成導致的死亡機率比再狹窄相對較高的（ 45％）， 患者通常需要再接受治療Thrombosis in general leads to a relatively higher chance of death (45%) compared with restenosis which usually results in need of re-treatment

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支架血栓的死亡率Death Following ST

隨訪期間（％） 植入支架後內血栓形成的死亡率Mortality During Follow up (%) Post-Stent Thrombosis

N=210 N=12634

HR 13.1 (9.8–17.5) P<0.0001

患者

%

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Wiviott SD, et al. Lancet. 2008.

最新型支架Latest Stent Available

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雙療法支架Dual Therapy Stent

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雙療法支架 (DTS)性質 Properties•全球第一隻擁有雙重療效的支架。結合了生物工程支架和藥物塗層支架的特性和優點，能同時修復血管内皮層並控制血管壁內膜增生A first-of-its-kind stent combining an anti-proliferative drug (on the abluminal surface) to control neointimal proliferation and an antibody (on the luminal surface) to accelerate endothelial coverage

強項 Advantages•支架外壁上塗有藥物，能抑制血管壁細胞增生而降低再狹窄的機會。支架内壁則附有抗體，加快血管內皮層自然修復，從減低早期及晚期血栓之形成Anti-proliferative drug reduces vessel re-narrowing whist antibody promotes endothelialization or stent coverage, reducing the risk of stent thrombosis.

弱項 Disadvantages•術後服用雙重抗血小板藥物的時間較裸支架及生物工程支架為長DAPT duration is longer than the period of Bare Metal Stent and Bio-engineered Stent

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雙療法支架 (DTS)

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雙療法支架 (DTS)

光學相干斷層掃描 (OCT)影像顯示植入單療法藥物塗層支架 9 個月後的支架

內膜覆蓋情況OCT images of a monotherapy DES

at 9 months with heterogeneous coverage

光學相干斷層掃描 (OCT)影像顯示植入雙療法支架 9 個月後的支架

內膜覆蓋情況OCT images of Dual Therapy Stent

at 9 months showing homogeneous coverage

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支架列表 Stent Choices   

祼金屬支架祼金屬支架(Bare Metal (Bare Metal

Stent)Stent)

藥物塗層支架藥物塗層支架(Drug-Eluting (Drug-Eluting

Stent)Stent)

生物工程支架生物工程支架(Bio-engineered (Bio-engineered

Stent)Stent)

全吸收式生物血管模架全吸收式生物血管模架(Bioresorbable (Bioresorbable

Vascular Vascular Scaffold)Scaffold)

雙療法支架雙療法支架(Dual Therapy (Dual Therapy

Stent)Stent)

性質性質 純金屬支架，植入血管後能令阻塞的血管張開

表面塗有藥物的金屬支架；藥物會抑制血管內膜增生，防止血管再度收窄

支架表面塗有抗體，抗體會吸附血管中的内皮祖細胞，加快支架表面自然修復過程

塗有藥物的可溶性模架會隨著時間分解然後被人體自然吸收

全球第一隻雙療法支架。結合了生物工程支架和藥物塗層支架的特性。支架內壁附有抗體，吸引血液中的內皮組細胞，加快血管自然修復過程；而支架外壁塗有藥物，抑制平滑肌細胞及血管內膜增生

強項強項 1. 第一代傳統裸金屬支架2. 費用相對便宜3. 手術後只需服用一個月雙重抗血小板藥 ( 如：柏域斯及阿士匹靈 )

1. 有效減低心血管再次收窄機率

1. 加速血管自然修復2. 減低晚期血栓及血管再收窄的機率3. 毋須長期服用雙重抗血小板藥物，但醫生一般建議手術後服用此藥物一個月

1. 藥物能抑制血管內膜增生，減低血管再次收窄機會2. 模架在植入血管兩年後消失

1. 能同時減低心血管再次收窄率，並加快支架表面修復從而減低血栓發生率

弱項弱項 因放入支架後會引致血管受損，令血管內壁的細胞會過度增生，導致血管再次收窄的機會相對較高

手術後因抑制了血管內膜的增長，有礙血管癒合，增加支架內形成血栓的機會，故需要長期(不少於 12 個月 )服用雙重抗血小板藥物

生物工程支架加快血管自然癒合過程，它沒有抑制細胞生長的藥物塗層，因此第一年再收窄的機會略高於藥物塗層支架

由於這種模架的獨特物料結構的關係，患有血管嚴重鈣化，迂曲或分叉病變等之病人可能不適用

服用雙重抗血小板藥物時間比裸金屬支架較長

手術後服藥手術後服藥時間時間

1 個月 12 個月 1 個月 12 個月 6 個月( 根據 REMEDEE臨床研究指引 )

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手術後的藥物治療Post Surgery Medication Treatment

• 雙重抗血小板藥物是指阿士匹靈及氯格雷兩種抗血小板藥物，作用是減低裝有支架的血管部位血塊形成的機會，從而減低血栓的風險Dual-antiplatelet therapy (DAPT) with aspirin and a thienopyridine ( clopidogrel or ticlopidine) reduces blog clotting/ thrombotic events

• 五種支架由於其原理不同，所需服食雙重抗血小板藥物的時間長度亦不同 The period of DAPT varies among patients implanted with the five different type of stents

• 醫生一般建議植入裸金屬支架及生物工程抗體支架的病人服藥 1 個月，而植入藥物塗層支架及全吸收式生物血管模架的病人則須服用 12 個月或以上 。植入雙療法支架的病人，根據研究指引，建議服藥 6 個月Normally doctor would recommend patients who implanted BMS or Bio-engineered Stents to undergo 1-month DAPT, while patients who implanted DES or BVS need to undergo more than 12 months or above DAPT. For those with DTS, according to study’s protocol, 6 months is recommended

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調查總結CONCLUSION

對支架選擇認知不足Low Awareness about Stent Selection•現時香港共有五種支架可供選擇 - 裸金屬支架、藥物塗層支架、生物工程支架、全吸收式生物血管模架及最新推出的雙療法支架。接近三成受訪者未能講出市面任何一種的名稱，僅一成七認識三種或以上支架There are 5 types of stent available for PCI – Bare Metal Stent, Drug Eluting Stent, Bio-engineered Stent, Bioresorbable Vascular Scaffold and the latest Dual Therapy Stent. About 30% of respondents could not name any types of stent available in the market; Less than 18% of the respondents were able to give the name of 3 or more types of stent in the market

•接近兩成受訪者不清楚自己血管內所植入的支架類型18% of respondents did not know the type of stents that has been implanted in their vessels

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調查總結CONCLUSION

對支架選擇認知不足Low Awareness about Stent Selection•逾半受訪者並沒有主動了解不同心臟支架種類的資訊，表明患者了解支架的種類風險、成效的主動性不高More than half of the respondents did not proactively look for or try to understand more information about coronary stents . It shows that patients’ intention to know more about the treatment methods is low

•接近一半 (47%) 的受訪者表示並不清楚不同的心臟支架，醫生所建議的服藥時期有所不同；一般來說， 不帶藥及有抗體塗層的支架服藥期較短， 而藥物塗層支架則需長期 (不少於 12 個月 ) 服用雙重抗血小板藥物47% of the respondents did not know that the medication period varies according to stent. In general, medication treatment after implanting stents without drug or with antibody-coating would be shorter. With Drug Eluting Stents, patients would be required to take longer period (not less than 12 months) of dual antiplatelet therapy

•建議病人在進行「通波仔」之前應主動瞭解清楚各種支架選擇的特質，和醫生商量最為適合自己身體狀況的支架It is recommended that patients should proactively talk to their doctor to learn more about different types of stent, so as to select the most suitable one for themselves

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調查總結CONCLUSION

對植入支架後服用藥物認知不足Low Awareness about Medication after Stenting•雙重抗血小板藥物的作用為減低血塊形成的機會，降低血管栓塞的風險。超過九成受訪者於術後需服用雙重抗血小板藥物 12 個月或以上，逾半更需要永久服用。 不過，仍有逾七成半受訪者曾經於沒有醫生指示下自行停藥，當中原因以忘記服用為最多 (66%) ，亦有人表示因不知道是否需要或認為不需要而決定暫停或停止服用雙重抗血小板藥物The use of DAPT is for preventing the formation of blood clots in order to reduce the risk of thrombosis. Over 90% of respondents have been instructed to take DAPT for 12 months or more, more than 50% need to take DAPT for life. However, more than 70% of the respondents had stopped taking DAPT without doctor’s instruction, most of them (66%) said they have forgotten to. Some of them expressed that they suspended or terminated due to uncertainty of the need of the medication or felt that there was no need to take the medication

•逾一成受訪者表示即使沒有醫生沒有許可， 服藥後身體狀況好轉或感到不適會自行停藥， 低估自行停藥的風險There were still more than 10% of the respondents expressed that they would stop taking DAPT without doctor’s permission if they feel better or experience side effect symptoms after taking the medication. The figures show that the risk of stopping taking DAPT has been underestimated

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調查總結CONCLUSION

對植入支架後服用藥物認知不足Low Awareness about Medication after Stenting•僅 4 人 (1.9%) 意識到擅自停藥或會導致死亡，嚴重低估服用雙重抗血小板藥物的重要性Only 4 respondents (1.9%) mentioned that it may lead to death, the importance of taking DAPT has not been taken seriously

•建議冠心病患者應清楚理解支架所需服食藥物的功用及擅自停藥所引發的血栓風險，並在手術後按照醫生的囑咐按時服藥It is recommended that patients should understand clearly the risk associated with DAPT termination and follow doctor’s instruction to take drugs on time

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調查總結CONCLUSION

提高市民對冠心病的警覺性To Enhance Public Awareness about Coronary Heart Disease•即使已接受過「通波仔」手術，仍然有超過四成受訪者對閱讀有關「通波仔」手術的資料不感興趣， 顯示市民對冠心病的警覺性不足Although all the participants have undertaken PCI, still over 40% of respondents were not interested in reading information related to PCI. This figure shows that public awareness on coronary heart disease is low

•超過八成受訪者表示通過健康講座或小冊子瞭解心臟病療法，表明除醫生外， 患者能於多個途徑接觸到心臟病資訊。建議關心您的心及業界應加強在這方面的推廣， 進一步提高大眾對冠心病的警覺性Over 80% of respondents indicated that health talks, leaflets and booklets were the main source of getting information about treatments of heart disease other than from their doctors. This figure shows that patients are able to reach heart disease information from multiple channels. It is suggested that Care For Your Heart and the industry should enhance the promotion of patient education, to further raise the public awareness of coronary disease

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「關心您的心」近期活動Upcoming Activities

08/12/2013 星期日同行萬步護心路

2013Walk For Your Heart

9.30am ~ 1.00pm

*特設心臟病知識展覽供公眾人士觀閱 *

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謝謝！THANK YOU!