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AuthorEl-Hajj, Maguy S.
AuthorSaad, Ahmed
AuthorAl-Suwaidi, Jassim
AuthorAl-Marridi, Wafa Z.
AuthorElkhalifa, Dana H.
AuthorMohamed, Alaa A.
AuthorMahfoud, Ziyad R.
Available date2021-09-01T10:03:25Z
Publication Date2016
Publication NameCurrent Vascular Pharmacology
ResourceScopus
URIhttp://dx.doi.org/10.2174/1570161114666160226150336
URIhttp://hdl.handle.net/10576/22430
AbstractBackground and Objectives: In Qatar, ACS (Acute Coronary Syndrome) has become the leading cause of morbidity and mortality. Guidelines recommend that ACS patients should receive indefinite treatment with antiplatelets, β-blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and statins. The study objectives were to assess the use of evidence-based secondary prevention medication at discharge among ACS patients in Qatar and to determine the clinical and demographic characteristics associated with the use of these medications. Setting and Methods: A retrospective medical record review was conducted at the Heart Hospital in Qatar. A random sample of 1068 ACS patients was selected. Patient characteristics were summarized. Prevalence of medications at discharge were computed for each medication as well as for medication combinations. Multiple logistic regression was used to detect patient variables that were associated with the outcomes. A p≤0.05 was considered significant. Main Outcome Measures: -Percentage of ACS patients discharged on each of the following medications: antiplatelets (aspirin, clopidogrel), β-blockers, ACEI or ARBs and statins and on the combination of these medications-Association between the use of these medications and patient characteristics. Results: In total, 1064 records were reviewed. The majority were males (85.3%) and about 1 in 5 (18.7%) were Qatari. At discharge, patients were prescribed the following: aspirin (96.0%), clopidogrel (92.0%), -blockers (90.6%) and statins (97.7%). ACEI and ARBs were prescribed to 63.5 and 11.3%, respectively. The concurrent 4 medications (aspirin or clopidogrel, statins or other lowering cholesterol medication, β-blockers and ACEI or ARB) were prescribed to 773 patients (77.8%; 95% confidence interval: 75.2-80.4%). Being overweight or obese, and having PCI (percutaneous coronary intervention) or hypertension were associated with higher prescription of the concurrent medications. Those with diabetes had a 52% increase in the odds of prescribing the 4 medications. Those with kidney disease had a 67% reduction in the odds of prescribing. Conclusion: Most ACS patients were prescribed antiplatelets, β-blockers and statins, but the use of ACEIs or ARBs was suboptimal. Strategies are needed to enhance ACEI or ARB prescribing, especially for high risk patients who would have the greatest therapeutic benefit from these drugs.
Languageen
PublisherBentham Science Publishers
Subjectacetylsalicylic acid
angiotensin receptor antagonist
atorvastatin
clopidogrel
dipeptidyl carboxypeptidase inhibitor
fluindostatin
lisinopril
metoprolol
mevinolin
pitavastatin
pravastatin
rosuvastatin
simvastatin
thienopyridine derivative
ticagrelor
valsartan
angiotensin 1 receptor antagonist
antithrombocytic agent
beta adrenergic receptor blocking agent
cardiovascular agent
dipeptidyl carboxypeptidase inhibitor
hydroxymethylglutaryl coenzyme A reductase inhibitor
acute coronary syndrome
adult
aged
Article
body mass
chronic kidney disease
diabetes mellitus
evidence based medicine
female
human
hypertension
ischemic heart disease
major clinical study
male
obesity
outcome assessment
percutaneous coronary intervention
prescription
Qatar
retrospective study
acute coronary syndrome
clinical practice
hospital discharge
middle aged
multivariate analysis
odds ratio
practice guideline
procedures
protocol compliance
risk factor
secondary prevention
statistical model
Acute Coronary Syndrome
Adrenergic beta-Antagonists
Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Cardiovascular Agents
Evidence-Based Medicine
Female
Guideline Adherence
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Patient Discharge
Platelet Aggregation Inhibitors
Practice Guidelines as Topic
Practice Patterns, Physicians'
Qatar
Retrospective Studies
Risk Factors
Secondary Prevention
TitleUtilization of evidence-based secondary prevention medications at the time of discharge in patients with acute coronary syndrome (ACS) in Qatar
TypeArticle
Pagination394-403
Issue Number4
Volume Number14
dc.accessType Abstract Only


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