Information from the abstract
The use of secondary prevention medications after acute coronary syndrome (ACS) is commonly suboptimal despite strong evidence and recommendations for their benefits. This study aimed to compare the usage rates of secondary prevention medications between the post-percutaneous coronary intervention (PCI) clinic, a coordinated, multidisciplinary service for patients who underwent cardiac stenting after ACS, and the historical control group. This single-center, retrospective cohort study with a historical control was performed in ACS patients undergoing PCI during 2015–2020 in a tertiary care hospital in Thailand. Primary outcomes were the usage rates of secondary prevention medications including antiplatelets, high-intensity statins, beta blockers, and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) at 3, 6, and 12 months. Secondary outcomes included all-cause rehospitalization, recurrent myocardial infarction, and death. Finally, there were 273 and 1,050 patients in the control and intervention groups, respectively. Baseline characteristics between the two groups were mostly similar, with a mean age of 59.44 ± 12.29 years. After adjustment for confounding factors, the usage rate of high-intensity statins was higher in the intervention group compared to the control group at 3, 6, and 12 months with adjusted odds ratios (aORs) of 2.40 (95% CI: 1.49 − 3.88), 2.01 (95% CI: 1.16 − 3.49), and 2.23 (95% CI: 1.24 − 4.00), respectively. Similarly, the usage rate of ACEIs/ARBs was consistently higher in the intervention group across all follow-up periods. Patients in the intervention group also had a lower rate of all-cause rehospitalization (adjusted hazard ratio [aHR]: 0.53; 95% CI: 0.42 − 0.67; p < 0.001) and recurrent myocardial infarction (aHR: 0.52; 95% CI: 0.28 − 0.94; p = 0.03). The post-PCI clinic was associated with improved optimization of secondary prevention medications and favorable clinical outcomes. in ACS patients post-stenting. Although limited by its single-center, retrospective design and historical control group, this model provides a scalable framework for secondary prevention in tertiary care settings. Not applicable.
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Related topics: Antiplatelet Therapy and Cardiovascular Diseases · Coronary Interventions and Diagnostics · Pharmaceutical Practices and Patient Outcomes
Thai researcher and institutional participation
Rachata Mungkornkaew · Thidarat Manapattanasatien · Wipharak Rattanavipanon · Chanikarn Kanaderm · Nuanchan Phanthumetamat · Surakit Nathisuwan · Mahidol University · Ubon Ratchathani University · Pathumthani University · Rangsit University · Central Chest Institute of Thailand
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