In:
European Heart Journal, Oxford University Press (OUP), Vol. 41, No. Supplement_2 ( 2020-11-01)
Abstract:
There is scarcity of studies from the Middle East had address the use of guideline-recommended secondary cardiovascular prevention medications among individuals who survived at least one decade after coronary revascularization (CR) by percutaneous coronary intervention (PCI) or coronary bypass graft surgery (CABG). Purpose An objective of the DECADE-PLUS study was to evaluate the use of antiplatelet agents (APA), statins, beta blockers (BB) and renin-angiotensin system inhibitors (RASI) in such patients. Methods We enrolled consecutive patients seen at ambulatory or in-patient settings with the following inclusion criteria: patient had PCI or CABG & gt;10 years ago, age & gt;18 years at the time of the index CR, and availability of data of currently used medications. Results Of 892 patients enrolled, 600 (67.3%) had PCI and 292 (32.7%) had CABG. Patients had CR & gt;20 years ago (100; 11.2%), 11–19 years ago (536; 60.1%) or 10 years ago (256; 28.7%). Women comprised 13.8% of the whole cohort, and mean age at index CR was 53.4+9.4 years. Hypertension, diabetes mellitus, and dyslipidemia were present in 398 (44.6%), 351 (39.3%) and 290 (32.5%), respectively at the time of CR. Overall, aspirin was used in 745 (83.5%), and a second APA in 329 (36.9%). Statins, BB and RASI were used in 83.7%, 71.7% and 54.3%, respectively. Univariate analysis of predictors of lower rates of use of these medications showed that survival time (10 years vs. & gt;20 years), and revascularization type (PCI vs. CABG) had no impact on use of these medications. However, nondiabetics were less often prescribed second APA (odds ratio (OR) 0.78, p=0.005) and RASI (OR 0.85, p=0.007) compared with diabetics. Furthermore, compared with men, women were less often prescribed aspirin (OR 0.66, p & lt;0.0001), statin (OR 0.67, p & lt;0.0001), BB (OR 0.71, p=0.005), and RASI (OR 0.79, p=0.005). Conclusion Middle East patients surviving at least one decade after coronary revascularization have a high rate of utilization of secondary cardiovascular medications compared with western data. However, women and non-diabetic individuals have lower rate of use of these medications compared with diabetics and men, respectively. Larger studies are warranted to explore the reasons behind these discrepancies and thus represent potential targets for positive intervention. Funding Acknowledgement Type of funding source: None
Type of Medium:
Online Resource
ISSN:
0195-668X
,
1522-9645
DOI:
10.1093/ehjci/ehaa946.2957
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2020
detail.hit.zdb_id:
2001908-7
