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TCTAP A-034
Presenter
Manaswini Satla
Authors
Lokeswari Pinneboyana1, Manaswini Satla2, Ramyareddy Gangadi2
Affiliation
Koneru Lakshmaiah University, India1, Talla Padmavathi College of Pharmacy, India2
View Study Report
TCTAP A-034
Pharmacology/Pharmacotherapy
The Prevalence and Predictors of Guideline Directed Medical Therapy in Patients with Acute Coronary Syndrome
Lokeswari Pinneboyana1, Manaswini Satla2, Ramyareddy Gangadi2
Koneru Lakshmaiah University, India1, Talla Padmavathi College of Pharmacy, India2
Background
• Evidence for Guideline Directed Medical Therapy in Patients with Acute Coronary Syndrome comes from randomized controlled trials. The use of Guideline Directed Medical Therapy in clinical practice is unknown in this setting.
Study Design:• Prospective, cross-sectional studies, Observational studies.
Study Design:• Prospective, cross-sectional studies, Observational studies.
Methods
• All the enrolled hospitalised patients' data(SAMRAKSHA MULTISPECIALITY HOSPITAL) is collected from their medication charts, notes, and collected data is documented in a suitably designed data collection form.
• All collected data were analysed using a relevant statistical method (multivariable logistic regression analysis).
• GDMT was defined according to American College of Cardiology/American Heart Association(ACC/AHA) class I recommendations, specifically, dual antiplatelet therapy, statin and beta-blocker for all AMI patients, and additional ACEI/ARB in patients with left ventricular ejection fraction (LVEF) less than 40%, hypertension, diabetes mellitus (DM)
• All collected data were analysed using a relevant statistical method (multivariable logistic regression analysis).
• GDMT was defined according to American College of Cardiology/American Heart Association(ACC/AHA) class I recommendations, specifically, dual antiplatelet therapy, statin and beta-blocker for all AMI patients, and additional ACEI/ARB in patients with left ventricular ejection fraction (LVEF) less than 40%, hypertension, diabetes mellitus (DM)
Results
A total of 353 patients were included in the study. In the total population, 60.05% were males and 39.9% were females. The mean age of the patients was 55.5years ±15.3 years. Out of 353 patients, 191 patients were already on medications where 24.07% were on oral hypoglycaemic agents and 30.02% were on antihypertensive agents. 23.51% of the total 353 patients were discharged with guideline directed medical therapy whereas 76.48% of the population were on non-guideline-directed medical therapy*Predictors of GDMT prescription at discharge.*
| content | Odds ratio | Confidence interval | p-value |
| Age>60 years | 0.6772 | 0.41-1.11 | 0.12 |
| Hypertension | 0.3754 | 0.22-0.64 | 0.0003 |
| Diabetes mellitus | 0.6556 | 0.29-1.50 | 0.32 |
| Acute coronary syndrome | 3.4465 | 0.19-62.9 | 0.4 |
| Hypothyroidism | 7.37 | 0.43-126.4 | 0.17 |
| Clopidogrel | 0.2795 | 0.06-1.21 | 0.09 |
| Ticagrelor | 1.1099 | 0.40-3.09 | 0.84 |
| Prasugrel | 6.1825 | 0.82-46.90 | 0.08 |
| Aspirin | 1.0798 | 0.04-26.76 | 0.96 |
| HTN with DM | 1.3273 | 0.65-2.7 | 0.43 |
| HTN with CAD | 2.1769 | 0.11-42.5 | 0.61 |
Conclusion
Our major findings were as follows: (1) 23.51% of patients for Acute Myocardial Infarction were prescribed GuidelineDirected Medical Therapy at discharge (2) Past Medical History representing acute coronary syndrome, hypothyroidism and comorbid conditions(Hypertensionwith Diabetes Mellitus, Hypertension with Coronary Artery disease) were positive predictors of Guideline Directed Medical Therapy prescription at discharge.