Key result
Optimal five-drug medical therapy reaches only ~45% of acute coronary syndrome patients at discharge.
Why the study?
Five-medication regimen is recommended for secondary prevention after ACS, but prescribing patterns at discharge in Sudan were not well characterized.
Cohort (n=591)
No
Highlights a quality gap in ACS secondary prevention; extends prior OMT underuse reports but leaves open effective interventions.
Background: Five-medication regimen is recommended for patients after acute coronary syndrome (ACS) as a secondary prevention strategy at discharge to reduce recurrence and improve mortality. Objective: This study aimed to assess prescribing of optimal medical therapy (OMT) as five-medication regimens for secondary prevention at discharge after ACS in Sudan. Methods: A retrospective cohort study was performed at a tertiary hospital located in Wad Medani, Sudan, in the period between January and December 2019. Data were collected from patients' files. OMT was defined as a combination of five medications; aspirin and P2Y12 inhibitors, statins, beta-blockers (BBs), and angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) or if a valid contraindication was documented. Results: Of the 619 patients throughout the study period, 591 were selected based on inclusion and exclusion criteria. The median age of patients was 60 years, and 58.9% of patients were male. Diabetes (44.5%) and hypertension (42%) were the most common risk factors. Most patients (58.4%) were diagnosed with ST-segment elevation myocardial infarction. About 99.7% of patients were on aspirin, 99.5% on statins, 97% on clopidogrel, 96.8% on dual antiplatelet therapy, 70.4% on BBs, and 57.9% on ACEIs/ARBs. OMT for secondary prevention was prescribed to 267 (45.2%) patients with ACS at discharge. Conclusion: Although prescriptions for all five guideline-recommended medications after ACS were suboptimal, the study showed a positive trend in prescribing most individual medications.
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A 2022 study conducted a cohort in Acute Coronary Syndrome (n=591). Guideline-recommended five-medication regimen for secondary prevention vs. Suboptimal medical therapy was evaluated on Prescription of all five guideline-recommended secondary prevention medications at discharge. Optimal medical therapy for secondary prevention, comprising a five-medication regimen, was prescribed to only 45.2% of patients with acute coronary syndrome at hospital discharge.
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