Key result
Full five-drug secondary prevention in ACS is linked to different 3-month quality of life scores.
Why the study?
The impact of secondary prevention drug use on quality of life in follow-up ACS patients was not well established.
Does the prescription of all 5 guideline-recommended secondary prevention drug groups improve quality of life in follow-up patients of acute coronary syndrome?
Cohort (n=525)
No
Does the prescription of all 5 guideline-recommended secondary prevention drug groups improve quality of life in follow-up patients of acute coronary syndrome?
Absolute Event Rate: 16.95% vs 11.86%
p-value: p=<0.0001
Prescription of all five guideline-recommended secondary prevention drug classes significantly improves quality of life in ACS patients compared to fewer classes.
Supports broader secondary prevention in ACS for potential QoL gains; hypothesis-generating and requires RCTs to confirm causality.
Introduction: Acute coronary syndrome (ACS) includes unstable angina, non-ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction. Joint guidelines by American College of Cardiology (ACC) and American Heart Association (AHA) in 2007 suggest secondary drug prevention measures to be used in patients with ACS with aspirin, clopidogrel/prasugrel, ACE inhibitors/ ARBs, Statins, Beta blockers. This study is aimed to find out impact of drug use in quality of life of ACS patients during follow up period. Materials and methods: It was a prospective unicentric study done at the OPD of cardiology,R.G.Kar Medical college, Kolkata. All prescriptions issued to study subjects attending the cardiology clinic during 18 months period were intercepted after consultation. Pattern of drug use was noted. Patients were asked 21 questions of “Minnesota living with heart disease questionnaire†and scores were calculated in 3 visits of each patient. Impact of drug use was calculated. Results: 525 patients were included in study. aspirin was given in 100%, clopidogrel/prasugrel in 98.29%, ACEI/ARB in 87.43%, statins in 100%, beta blockers in 86.86%. Total 408 patients were given drugs from all 5 groups. There was overall significant satisfactory improvement with drug therapy. Prescription of all 5 drug groups had significant better outcome in quality of life score than prescription of less than 5 drug groups. Conclusion: Drugs from all these 5 groups should be given to all follow up patients of ACS, unless contraindicated as they significantly improve quality of life of the patients. *- ACE- angiotensin converting enzyme, ARB- angiotensin receptor blocker. Â
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Ghosh et al. (2014) conducted a cohort in Acute coronary syndrome (n=525). Prescription of all 5 major secondary prevention drug groups (antiplatelets, beta blockers, ACEI/ARB, statins) vs. Prescription of less than 5 major drug groups was evaluated on Minnesota living with heart disease questionnaire score at 3 months (p=<0.0001). Prescription of all 5 major secondary prevention drug groups in patients with acute coronary syndrome was associated with a significant difference in quality of life scores at 3 months compared to those receiving fewer drug groups (p<0.0001).
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