The underutilization of adjunctive pharmacotherapy in treating acute coronary syndrome patients admitted to a tertiary care hospital in Southwest region, Saudi Arabia

Abstract

Background: Acute coronary syndrome (ACS) is the most prevalent cardiac disorder. Adjunctive pharmacotherapy has proved to be safe and effective in treating patients with this syndrome. Underutilization of such pharmacotherapy was reported in different studies. Objectives: In this study, we evaluated the underutilization of these pharmacotherapies on patients admitted to Aseer Central Hospital (ACH) with ACS, find out factors that may predict utilization of these therapies, and determine the effect of such pattern of drug utilization on survival at discharge. Materials and Methods: A retrospective cohort of 562 patients admitted with the diagnosis of ACS to ACH during the period from March 2007 to February 2009 was studied. Results: β-blockers (B-blocker) and angiotensin-converting enzyme inhibitors (ACEI) were used in only 69 and 59% of cases, respectively. Aspirin, clopidogrel, and statin were used in 98.4, 82.6, and 89.3% of cases, respectively. The presence of diabetes predicts the use of ACE inhibitors, whereas the diagnosis of unstable angina and ST-elevation myocardial infarction predict the use of statin. Survival rate at discharge was 95.6%. Use of statin and aspirin improved survival. Conclusion: Certain adjunctive pharmacotherapies were underutilized in ACS patients in Southwest region, Saudi Arabia, specifically β-blockers and ACEI. Standard of care should be revised and updated, aiming to improve adherence to guidelines of management of patients with ACS.

Keywords

• Adjunctive
• acute coronary syndrome
• pharmacotherapy
• underutilization