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Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome
Background: Cardiovascular disease, especially coronary disease, represents one of the main causes of morbidity and mortality. Objective: To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event. Methods: Cross-sectional study. W...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543101/ https://www.ncbi.nlm.nih.gov/pubmed/32755281 http://dx.doi.org/10.1177/2150132720946949 |
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author | Gaviria-Mendoza, Andrés Zapata-Carmona, Julián Andrés Restrepo-Bastidas, Andrés Alirio Betancur-Pulgarín, Carmen Luisa Machado-Alba, Jorge Enrique |
author_facet | Gaviria-Mendoza, Andrés Zapata-Carmona, Julián Andrés Restrepo-Bastidas, Andrés Alirio Betancur-Pulgarín, Carmen Luisa Machado-Alba, Jorge Enrique |
author_sort | Gaviria-Mendoza, Andrés |
collection | PubMed |
description | Background: Cardiovascular disease, especially coronary disease, represents one of the main causes of morbidity and mortality. Objective: To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event. Methods: Cross-sectional study. We included adult patients of any sex affiliated with one healthcare insurer of the Colombian Health System, with a diagnosis of a first episode of acute coronary syndrome that occurred during the period of 2015 to 2016. Sociodemographic, clinical and pharmacological variables were evaluated from clinical records. The cardiovascular risk score prior to the event was calculated, and the need for the use of statins and aspirin in primary prevention was defined according to the recommendations of clinical practice guidelines. Results: Clinical records of 322 patients were reviewed with mean age of 61.9 ± 10.8 years, and 77.3% were men. The most frequent comorbidities were dyslipidemia (64.3%), arterial hypertension (62.7%) and diabetes mellitus (30.1%); 22% of the patients were obese, and 33.5% were smokers. The cardiovascular risk score was calculated in 211 patients (65.5%) who had the necessary variables complete. The median 10-year risk according to Framingham risk score was 21.4%, and it was 16.3% according to the American Heart Association. From the 211 patients with risk scores, there were 179 (84.8%) who needed statins (175 of high intensity, 97.8%), and 88 (27.3%) required aspirin as a primary prevention; however, 56 of these patients (31.3%) did not receive any statins, 127 (72.6%) did not receive the high intensity statin they needed, and 38 (43.2% of those with indication) lacked aspirin. Conclusion: Real-life data show that among a group of patients with high cardiovascular risk, a substantial proportion were not receiving medications for primary prevention necessary to reduce their risk and finally suffered an acute coronary event. |
format | Online Article Text |
id | pubmed-7543101 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-75431012020-10-20 Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome Gaviria-Mendoza, Andrés Zapata-Carmona, Julián Andrés Restrepo-Bastidas, Andrés Alirio Betancur-Pulgarín, Carmen Luisa Machado-Alba, Jorge Enrique J Prim Care Community Health Original Research Background: Cardiovascular disease, especially coronary disease, represents one of the main causes of morbidity and mortality. Objective: To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event. Methods: Cross-sectional study. We included adult patients of any sex affiliated with one healthcare insurer of the Colombian Health System, with a diagnosis of a first episode of acute coronary syndrome that occurred during the period of 2015 to 2016. Sociodemographic, clinical and pharmacological variables were evaluated from clinical records. The cardiovascular risk score prior to the event was calculated, and the need for the use of statins and aspirin in primary prevention was defined according to the recommendations of clinical practice guidelines. Results: Clinical records of 322 patients were reviewed with mean age of 61.9 ± 10.8 years, and 77.3% were men. The most frequent comorbidities were dyslipidemia (64.3%), arterial hypertension (62.7%) and diabetes mellitus (30.1%); 22% of the patients were obese, and 33.5% were smokers. The cardiovascular risk score was calculated in 211 patients (65.5%) who had the necessary variables complete. The median 10-year risk according to Framingham risk score was 21.4%, and it was 16.3% according to the American Heart Association. From the 211 patients with risk scores, there were 179 (84.8%) who needed statins (175 of high intensity, 97.8%), and 88 (27.3%) required aspirin as a primary prevention; however, 56 of these patients (31.3%) did not receive any statins, 127 (72.6%) did not receive the high intensity statin they needed, and 38 (43.2% of those with indication) lacked aspirin. Conclusion: Real-life data show that among a group of patients with high cardiovascular risk, a substantial proportion were not receiving medications for primary prevention necessary to reduce their risk and finally suffered an acute coronary event. SAGE Publications 2020-08-05 /pmc/articles/PMC7543101/ /pubmed/32755281 http://dx.doi.org/10.1177/2150132720946949 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Gaviria-Mendoza, Andrés Zapata-Carmona, Julián Andrés Restrepo-Bastidas, Andrés Alirio Betancur-Pulgarín, Carmen Luisa Machado-Alba, Jorge Enrique Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title | Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title_full | Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title_fullStr | Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title_full_unstemmed | Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title_short | Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome |
title_sort | prior use of medication for primary prevention in patients with coronary syndrome |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543101/ https://www.ncbi.nlm.nih.gov/pubmed/32755281 http://dx.doi.org/10.1177/2150132720946949 |
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