SHEN Jiantong , YANG Xiaoyan , LI Youping , WANG Li , ZHOU Ping , XIN Zhemei , LI Honghao , WANG Yingqiang , LI Cuicui , LI Xiao , LI Xianglian , YANG Zongxia
  • Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
LI Youping, Email: yzmylab@hotmail.com
Township health center; Essential medicine; Evidence-based evaluation and selection; Coronary heart disease
10.7507/1672-2531.20120150
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Objective 　To evaluate and select essential medicine for the treatment of coronary heart disease by means of evidence-based approaches based on the burden of disease for township health centers located in eastern, central and western regions of China.
Methods 　By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence.
Results 　(1) 11 clinical guidelines on coronary heart disease were included, three of which are evidence-based guidelines. (2) Totally, those guidelines contained 61 medicines (of 13 classes). (3) According to WHOEML (2011), NEML (2009), CNF (2010), other guidelines and the quantity and quality of evidence, we made a b recommendation for nitroglycerin, isosorbide dinitrate, metoprolol, nifedipine, verapamil, enalapril and aspirin as essential medicine for coronary heart disease. We made a weak recommendation for amlodipine, clopidogrel, heparin, propranolol, simvastatin and streptokinase. (4) 13 recommended medicines have been marketed in China and their prices were affordable. (5) Results of domestic low-quality studies indicated that nitroglycerin, isosorbide dinitrate, metoprolol, aspirin and heparin were effective for coronary heart disease. We didn’t find systematic reviews or pharmacoeconomic studies on the recommended medicines in Chinese literature databases.
Conclusion 　For coronary heart disease: (1) We offer a b recommendation for nitroglycerin, isosorbide dinitrate, metoprolol, nifedipine, verapamil, enalapril and aspirin and a weak recommendation for propranolol, amlodipine, clopidogrel, heparin, simvastatin and streptokinase. (2) There is lack of high-quality evidence from relevant domestic studies, especially on pharmacoeconomic evaluation. (3) We propose that more studies should be carried out on clinical guideline of coronary heart disease and pharmacoeconomic comparison should be also made between recommended medicine and medicine of the same class.

Citation： SHEN Jiantong,YANG Xiaoyan,LI Youping,WANG Li,ZHOU Ping,XIN Zhemei,LI Honghao,WANG Yingqiang,LI Cuicui,LI Xiao,LI Xianglian,YANG Zongxia. Evidence-Based Evaluation and Selection of Essential Medicine for Township Health Centre in China: 11. Coronary Heart Disease. Chinese Journal of Evidence-Based Medicine, 2012, 12(8): 948-957. doi: 10.7507/1672-2531.20120150 Copy

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