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ABS20191126_0008
Pharmacology/Pharmacotherapy
The Impact of Short-Term Adherence to Dual Anti-Platelet Therapy (DAP) on 1-Year Mortality of Patients Undergoing Percutaneous Coronary Intervention (PCI)
Shaban Mohammed1, Abdulrahman Arabi1, Ahmed Moursi1, Ayman El-Menyar1, Salah Arafa1, Ihsan Rafie1, Awad Alqahtani1, Moza Al Hail1, Nidal Asaad1, Jassim Al Suwaidi2
Heart Hospital Hamad Medical Corporation, Qatar1, Heart hospital Hamad Medical Corporation, Qatar2
Background:
The aim of this study was to determine the impact of dual anti-platelet (DAP) compliance during the first 3 months following Percutaneous Coronary Intervention (PCI) on patientí»s outcome and mortality.
Methods:
Consecutive patients who had PCI at a tertiary cardiac care hospital in Qatar were included in the study in a period of October 2012 to March 2013 and followed-up for one year. The adherence to DAP was determined by the prescription refill post discharge as our institutional and national policy dictating prescription refilling only through our hospital. We compared clinical outcome and mortality rate between patients who refilled the prescription of DAP and those who did not refill the prescription after hospital discharge.
Results:
Five hundred fifty patients who underwent PCI were included. There was no significant difference in the composition of male gender or Arab ethnicity between the DAP adherent and non-adherent groups (91.6, 38.5 Vs 88, 45.4%, p=0.23, 0.41, respectively). Data revealed that percentage of patients who received í├6 medications (polypharmacy) was significantly higher in ADP non-adherent group compared to ADP adherent group (100.0 vs. 80.5%, p=< 0.001). The two groups were comparable in term of socioeconomic status (p= 0.49) and receiving medication counseling (p=0.095). At 18-month, rate of hospital readmission showed in-significant difference between the two groups (27.4 vs. 21.3, p= 0.2). On the other hand, ADP adherent group showed significant lower mortality at both 6 month and 1 year (3.2 and 1.8%, respectively) compared to ADP non-adherent group (8.3% and 7.4%). Multivariate logistic regression analysis showed that adherence to DAP in the first 3 months is an independent predictor for 1-year mortality rate reduction (Odds ratio: 0.143101, 95% confidence interval: 0.0419-0.4887, P =0.002).
Conclusion:
Adherence to the first 3 months course of DAP is associated with lower 1-year mortality rate. further studies are required to investigate parameters that contribute DAP short-term adherence.
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