The Trends of Pharmacological Therapy in one Month Post Myocardial Infarction Patients
Pharmacological Therapy in Myocardial Infarction Patients
DOI:
https://doi.org/10.54393/pjhs.v4i01.260Keywords:
Appropriate Drug, Appropriate Dosage, Myocardial InfarctionAbstract
Guideline recommended treatment has an important impact on the mortality and morbidity of post myocardial infarction patients. Objective: To assess the frequency of appropriate drug with its appropriate dosage of guideline recommended pharmacological therapy, prescribed by physician, in patients with Myocardial Infarction (MI). The cross sectional study conducted at National Institute of Cardiovascular Disease, Karachi from 1st January 2020 to 30th June 2020. Methods: Total 160 patients who came to hospital for follow-up after one month of Myocardial infarction were included in the study. Prescription was considered appropriate if the patient has taken at-least 5 out of 6 medications. At least 5 out of 6 along with its goal dose was considered as appropriate dosage. Descriptive statistics were calculated. Stratification was done. Chi-square test was applied post stratification and p-value ≤ 0.05 was considered as significant. Results: There were 103 male and 57 female patients. The mean age was 53.36 ± 8.10 years. Number of drugs used was found appropriate in 96.3% patients but the doses of drugs used was found appropriate in only 5.6% patients. Conclusions: The present study revealed that the majority of the physicians prescribed the recommended number of the drugs used; however, the doses of drugs used were not always according to the guidelines. It is important for cardiology physicians to understand the importance of guideline recommended pharmacological intervention among patients with a one-month history of MI.
References
Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology. 2021 Nov; 18(11): 785-802. doi: 10.1038/s41569-021-00559-8
Ralapanawa U and Sivakanesan R. Epidemiology and the magnitude of coronary artery disease and acute coronary syndrome: A narrative review. Journal of Epidemiology and Global Health. 2021 Jun; 11(2): 169-177. doi: 10.2991/jegh.k.201217.001
Neeland IJ, Poirier P, Després JP. Cardiovascular and metabolic heterogeneity of obesity: clinical challenges and implications for management. Circulation. 2018 Mar; 137(13): 1391-406. doi: 10.1161/CIRCULATIONAHA.117.029617
Boulanger M. Improving secondary prevention after transient ischaemic attack (TIA) or ischaemic stroke (Doctoral dissertation, Normandie Université). 2019. Available at: https://theses.hal.science/tel-03053329/
Bagnall AJ, Yan AT, Yan RT, Lee CH, Tan M, Baer C, et al. Optimal medical therapy for non-ST-segment-elevation acute coronary syndromes: exploring why physicians do not prescribe evidence-based treatment and why patients discontinue medications after discharge. Circ Cardiovasc Qual Outcomes. 2010 Aug; 3(5): 530-7. doi: 10.1161/CIRCOUTCOMES.109.919415
Kim YH, Her AY, Jeong MH, Kim BK, Lee SY, Hong SJ, et al. Comparison between beta-blockers with angiotensin-converting enzyme inhibitors and beta-blockers with angiotensin II type I receptor blockers in ST-segment elevation myocardial infarction after successful percutaneous coronary intervention with drug-eluting stents. Cardiovascular Drugs and Therapy. 2019 Feb; 33(1): 55-67. doi: 10.1007/s10557-018-6841-7
Huber CA, Meyer MR, Steffel J, Blozik E, Reich O, Rosemann T. Post-myocardial infarction (MI) care: medication adherence for secondary prevention after MI in a large real-world population. Clinical therapeutics. 2019 Jan; 41(1): 107-17. doi: 10.1016/j.clinthera.2018.11.012
Redfern J, Hyun K, Chew DP, Astley C, Chow C, Aliprandi-Costa B, et al. Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large perspective audit in Australia and New Zealand. Heart. 2014 Aug; 100(16): 1281-8. doi: 10.1136/heartjnl-2013-305296
Schulz M, Griese‐Mammen N, Anker SD, Koehler F, Ihle P, Ruckes C, et al. Pharmacy‐based interdisciplinary intervention for patients with chronic heart failure: results of the PHARM‐CHF randomized controlled trial. European Journal of Heart Failure. 2019 Aug; 21(8): 1012-21. doi: 10.1002/ejhf.1503
O’gara PT, Kushner FG, Ascheim DD, Casey Jr DE, Chung MK, De Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013 Jan; 127(4): 529-55.
De Luca L. Established and emerging pharmacological therapies for post-myocardial infarction patients with heart failure: a review of the evidence. Cardiovascular Drugs and Therapy. 2020 Oct; 34(5): 723-35. doi: 10.1007/s10557-020-07027-4
Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction. Jama. 2007 Jan; 297(2): 177-86. doi: 10.1001/jama.297.2.177
Ho PM, Magid DJ, Shetterly SM, Olson KL, Maddox TM, Peterson PN, et al. Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease. American Heart Journal. 2008 Apr; 155(4): 772-9. doi: 10.1016/j.ahj.2007.12.011
Kumbhani DJ, Steg PG, Cannon CP, Eagle KA, Smith Jr SC, Hoffman E, et al. Adherence to secondary prevention medications and four-year outcomes in outpatients with atherosclerosis. The American journal of medicine. 2013 Aug; 126(8): 693-700. doi: 10.1016/j.amjmed.2013.01.033
Simons LA, Ortiz M, Calcino G. Persistence with antihypertensive medication: Australia‐wide experience, 2004–2006. Medical Journal of Australia. 2008 Feb; 188(4): 224-7. doi: 10.5694/j.1326-5377.2008.tb01589.x
Roughead EE, Vitry AI, Preiss AK, Barratt JD, Gilbert AL, Ryan P. Assessing overall duration of cardiovascular medicines in veterans with established cardiovascular disease. European Journal of Preventive Cardiology. 2010 Feb; 17(1): 71-6. doi: 10.1097/HJR.0b013e32832f3b56
Mukherjee D, Fang J, Chetcuti S, Moscucci M, Kline-Rogers E, Eagle KA. Impact of combination evidence-based medical therapy on mortality in patients with acute coronary syndromes. Circulation. 2004 Feb; 109(6): 745-9. doi: 10.1161/01.CIR.0000112577.69066.CB
Ho PM, Spertus JA, Masoudi FA, Reid KJ, Peterson ED, Magid DJ, et al. Impact of medication therapy discontinuation on mortality after myocardial infarction. Archives of Internal Medicine. 2006 Sep; 166(17): 1842-7. doi: 10.1001/archinte.166.17.1842
Arnold SV, Spertus JA, Masoudi FA, Daugherty SL, Maddox TM, Li Y, et al. Beyond medication prescription as performance measures: optimal secondary prevention medication dosing after acute myocardial infarction. Journal of the American College of Cardiology. 2013 Nov; 62(19): 1791-801. doi: 10.1016/j.jacc.2013.04.102
Solomon MD, Leong TK, Levin E, Rana JS, Jaffe MG, Sidney S, et al. Cumulative adherence to secondary prevention guidelines and mortality after acute myocardial infarction. Journal of the American Heart Association. 2020 Mar; 9(6): e014415. doi: 10.1161/JAHA.119.014415
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