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. 2022 Jan;54(1):102157.
doi: 10.1016/j.aprim.2021.102157. Epub 2021 Oct 27.

Pharmacological treatment after acute coronary syndrome: Baseline clinical characteristics and gender differences in a population-based cohort study

Gerard Sotorra-Figuerola  1 , Dan Ouchi  1 , Ana García-Sangenís  1 , Maria Giner-Soriano  2 , Rosa Morros  3
Affiliations

Pharmacological treatment after acute coronary syndrome: Baseline clinical characteristics and gender differences in a population-based cohort study

Gerard Sotorra-Figuerola et al. Aten Primaria. 2022 Jan.

Abstract
in English, Spanish

Objective: To describe baseline socio-demographic and clinical characteristics and drugs prescribed for secondary prevention after a first episode of ACS and to assess differences between men and women.

Setting: PHC in Catalonia.

Data source: SIDIAP (Information System for Research in Primary Care).

Participants: Patients who suffered an ACS during 2009-2016 and followed-up in PHC centres of the Catalan Health Institute in Catalonia.

Interventions: Not applicable.

Main measures: Socio-demographic and clinical characteristics at baseline: sex, age, socioeconomic index, toxic habits, comorbidities, study drugs (prescribed for cardiovascular secondary prevention: antiplatelets, betablockers, statins, drugs acting on the renin-angiotensin system) and comedications.

Results: 8071 patients included, 71.3% of them were men and 80.2% had an acute myocardial infarction. Their mean age was 65.3 and women were older than men. The most frequent comorbidities were hypertension, dyslipidaemia and diabetes and they were more common in women. Antiplatelets (91.3%) and statins (85.7%) were the study drugs most prescribed. The uses of all comedications were significantly higher in women, except for nitrates. The combination of four study groups was initially prescribed in 47.7% of patients and combination of beta-blockers, statins and antiplatelets was prescribed in 18.4%. More men than women received all recommended pharmacological groups.

Conclusion: Women were older, had more comorbidities and received more comedications. Most patients were treated with a combination of four or three study drugs for secondary prevention. Men initiated more drug treatments for secondary prevention and dual antiplatelet therapy than women.

Eupas register: EUPAS19017.

Objetivos: Describir las características sociodemográficas y clínicas basales, y los fármacos prescritos para la prevención cardiovascular secundaria tras un síndrome coronario agudo (SCA). Analizar si existen diferencias entre varones y mujeres.

Emplazamiento: Atención primaria (AP) en Cataluña. Fuente de datos: Sistema de Información para el Desarrollo de la Investigación en AP (SIDIAP).

Participantes: Pacientes que hayan sufrido un primer SCA durante 2009-2016, seguidos en AP del Instituto Catalán de la Salud en Cataluña.

Intervenciones: No aplica.

Mediciones principales: Características sociodemográficas y clínicas al inicio: sexo, edad, índice socioeconómico, hábitos tóxicos, comorbilidades, fármacos de estudio (prescritos para prevención secundaria: antiagregantes, betabloqueantes, estatinas, fármacos del sistema renina-angiotensina) y fármacos concomitantes.

Resultados: Se incluyeron 8.071 pacientes; 71,3% varones y 80,2% habían sufrido infarto. La edad media era de 65,3 años y las mujeres eran mayores que los varones. Las comorbilidades más frecuentes fueron hipertensión, dislipemia y diabetes; más comunes en mujeres. Antiagregantes (91,3%) y estatinas (85,7%) fueron los fármacos más prescritos. El uso de todas las comedicaciones era más frecuente en mujeres, excepto nitratos. La combinación de los 4 grupos farmacológicos de estudio se prescribió al 47,7% de los pacientes incluidos y la combinación de antiagregante, betabloqueante y estatina al 18,4%. Más varones que mujeres recibieron los fármacos recomendados.

Conclusiones: Las mujeres incluidas eran mayores, con más comorbilidad y mayor uso de comedicaciones. La mayoría de pacientes eran tratados con la combinación de 3 o 4 fármacos para prevención secundaria. Los varones iniciaban más fármacos para prevención secundaria y más terapia antiagregante doble que las mujeres.

EUPAS Register: EUPAS19017.

Keywords: Acute coronary syndrome; Adherencia a la medicación; Drug adherence; Electronic health records; Prevención secundaria; Registros electrónicos de salud; Secondary prevention; Síndrome coronario agudo.

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Figures

None
Scheme 1. General outline of the study: Study flowchart. Includes the flowchart of patient's inclusion and exclusion for the study. ACS, acute coronary syndrome; AMI, acute myocardial infarction.
Figure 1
Figure 1
Study drugs combinations. This figure depicts N and % of patients initiating any possible combination of the drugs used for secondary prevention. ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin-receptor blockers; AntiPL, antiplatelets.
Figure 2
Figure 2
Drugs prescribed per gender. Fig. 2 depicts the different drugs prescribed overall, in men and women. Distribution between genders was compared using the Chi-Square test with all p-values < 0.001. ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin-receptor blockers.
See this image and copyright information in PMC

References

    1. World Health Organization . 2014. Global status report on noncommunicable diseases. Available from: https://www.who.int/nmh/publications/ncd-status-report-2014/en/ - PubMed
    1. Khan M.A., Hashim M.J., Mustafa H., Baniyas M.Y., Al Suwaidi S.K.B.M., AlKatheeri R. Global epidemiology of ischemic heart disease: results from the global burden of disease study. Cureus. 2020;12:e9349. - PMC - PubMed
    1. Mensah G.A., Wei G.S., Sorlie P.D., Fine L.J., Rosenberg Y., Kaufmann P.G. Decline in cardiovascular mortality. Circ Res. 2017;120:366–380. - PMC - PubMed
    1. Crowley M.J., Zullig L.L., Shah B.R., Shaw R.J., Lindquist J.H., Peterson E.D. Medication non-adherence after myocardial infarction: an exploration of modifying factors. J Gen Intern Med. 2015;30:83–90. - PMC - PubMed
    1. Sanfélix-Gimeno G., Peiró S., Ferreros I., Pérez-Vicente R., Librero J., Catalá-López F. Adherence to evidence-based therapies after acute coronary syndrome: a retrospective population-based cohort study linking hospital, outpatient, and pharmacy health information systems in Valencia, Spain. J Manag Care Pharm. 2013;19:247–257. - PMC - PubMed

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