Why the study?
Clinical guidelines recommend cardioprotective medications for patients with established CHD, but suboptimal use has been reported and data from South America are scarce.
What is the prevalence of cardioprotective medication use in patients with established coronary heart disease in South America?
What is the prevalence of cardioprotective medication use in patients with established coronary heart disease in South America?
The use of cardioprotective medications in South American CHD patients has increased over time but remains suboptimal, particularly in community settings.
May support targeting community and public settings to close remaining gaps now; extends scarce South American data and leaves open implementation strategies.
Background: Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but information from South America is scarce. Methods: We conducted a systematic review on prevalence of secondary prevention medication in South America. We pooled prevalence estimates, analysed time-trends and guideline compliance, and identified factors associated with medication use with meta-regression models. Results: 73 publications were included. Medication prevalence varied by class: beta-blockers 73.4%(95%CI 66.8%-79.1%), ACEI/ARBs 55.8%(95%CI 49.7%-61.8), antiplatelets 84.6%(95%CI 79.6%-88.5%), aspirin 85.1%(95%CI 79.7%-89.3%) and statins 78.9%(95%CI 71.2%-84.9%). The use of beta-blockers, ACEI/ARBs and statins increased since 1993. Ten publications reported low medication use and nine reported adequate use. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres. Conclusion: Cardioprotective medication use has increased, but could be further improved particularly in community settings.
No takes yet. Share an insight, caveat, or question.
Drotos et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: