Prescription patterns and their appropriateness within guidelines in chronic coronary syndrome patients

Abstract

Chronic coronary syndrome (CCS) is a disease that can progress to an acute fatal phase, and appropriate intervention with first-line CCS drugs (aspirin, beta-blockers, angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), and statin) is crucial to reduce cardiovascular mortality. This study aims to describe the prescription patterns and their appropriateness within guidelines in CCS patients. This is a descriptive cross-sectional study conducted in a central general tertiary hospital in Bandung, where data are collected retrospectively to include CCS patients. Data are excluded when information on prescription and contraindication factors in those not receiving first-line drugs is absent. 152 patients are included for analysis, where the majority are male with a median of 60.5 years from an outpatient setting and mostly having a history of hypertension and prior myocardial infarction (MI). Most prescribed medications are first-line CCS drugs: statin (99.3%), beta-blockers (87.5%), ACEi/ARB/ARNI (87.5%), and aspirin (83.6%). In addition, 97.7% have received at least one antithrombotic, only 66.2% received high-intensity statin, and only 1.9% achieved an low-density lipid level target below 55 mg/dl. After accounting for contraindication factors, appropriateness within guidelines in CCS patients reaches 82.2%. In conclusion, most prescribed medications are first-line CCS drugs, and appropriateness within guidelines is high, but improvement in high-intensity statin use is still needed.