Abstract 179: Documented Medication Use among Coronary Artery Disease Outpatients in India: Insights from PINNACLE India Outpatient Registry

Abstract

Introduction: Coronary artery disease (CAD) affects Indians with greater frequency and at a younger age than people in other countries, and is the leading cause of death in India. For patients with CAD, treatment is aimed at controlling symptoms and progression of disease through lifestyle change and medication therapy. Secondary prevention with medication therapy reduces cardiac mortality and CAD-related complications. To our knowledge, there is no published literature that details medication use in India among CAD patients. In a country that is in the midst of an escalating CVD epidemic, examining documented medication patterns for CAD in India is needed to focus prevention and control efforts. Methods: PINNACLE India is the first CV data collection and reporting program implemented in India. The database receives clinical data through transmission from paper scanners and an electronic data collection tool. Patients are followed longitudinally if they return to a data collecting outpatient site. Results: A total of 9,047 patients in PINNACLE India are documented as having CAD. Aspirin, Beta Blockers and Clopidogrel are the three most frequently documented medications. Conclusion: A study examining US PINNACLE data found among CAD patients eligible, beta-blockers were prescribed in 73.3% (63,800/86,999), ACEI/ARBs in 69.4% (55,933/80,552), and statins in 68.2% (18,833/27,628) of patients. Although the rates of documented medication use among CAD patients in the PINNACLE India registry is lower than in PINNACLE US, contraindications are not often documented in PINNACLE India, and thus, not all patients in our cohort may have been eligible for such medications, which may explain the lower rates of usage. Additionally, we suspect under-documentation of medications that are inexpensive and readily available, such as aspirin. While the data on documented medication use among CAD patients in PINNACLE India are still limited, the information it reveals thus far elicits meaningful questions. Taking a closer examination at the trends in medication use in the Indian population would impel investigation into the socioeconomic, cultural, and genetic factors that influence CAD prevalence in this country.