Analysis of secondary prevention measures implemented in patients with a history of acute coronary syndrome

Abstract

ObjectiveTo determine the pharmacological measures implemented for secondary prevention in patients with acute coronary syndrome in order to identify whether the implemented management corresponds to recommended clinical practice guidelines and to intervene in those cases where incomplete treatments are found. MethodsA pre- and post-quasi-experimental study was performed in patients with acute coronary syndrome who were affiliated with the Colombian health system. The patients were monitored for one year from the occurrence of acute coronary syndrome, and all dispensed medications were reviewed. For those patients in whom a lack of a prescription (β-blockers+renin-angiotensin-aldosterone system inhibitors (RAASi)+dual antiaggregation+statin) was identified, an intervention was performed with their treating physicians, showing the analysis of each case, the missing medication, and the evidence supporting the recommendation. The results were measured three months later. ResultsA total of 829 patients with acute coronary syndrome who underwent percutaneous coronary intervention (90.1%) or coronary bypass (9.9%) were identified. The mean age was 63.8±10.6 years and 73.1% were men. The recommended pharmacological therapy was completed in 729 patients (87.9% of cases). The intervention performed on the remaining 100 patients was able to add the missing drug in 23.0% of the cases. Statistical analysis showed no significant differences with the drug that should have been initiated nor with the success of the intervention. ConclusionThe majority of patients with acute coronary syndrome are adequately treated after percutaneous intervention with medications recommended by the guidelines. Limited success in the adjustment of the management acute coronary syndrome was achieved following the recommendations given to the responsible physicians.