Key result
Multidisciplinary post-PCI clinics linked to ~2.2-fold higher use of high-intensity statins at 12 months.
Why the study?
The use of secondary prevention medications after ACS is commonly suboptimal despite strong evidence and recommendations for their benefits.
Does a pharmacist-led multidisciplinary post-PCI clinic improve the usage rates of guideline-directed secondary prevention medications and clinical outcomes in patients post-ACS stenting?
Cohort (n=1,323)
No
Does a pharmacist-led multidisciplinary post-PCI clinic improve the usage rates of guideline-directed secondary prevention medications and clinical outcomes in patients post-ACS stenting?
Odds Ratio: 2.23 (95% CI 1.24–4)
A pharmacist-led multidisciplinary post-PCI clinic significantly improved the optimization of guideline-directed secondary prevention medications and reduced rates of 1-year rehospitalization and recurrent MI in ACS patients compared to usual care.
Background The use of secondary prevention medications after acute coronary syndrome (ACS) is commonly suboptimal despite strong evidence and recommendations for their benefits. This study aimed to compare the usage rates of secondary prevention medications between the post-percutaneous coronary intervention (PCI) clinic, a coordinated, multidisciplinary service for patients who underwent cardiac stenting after ACS, and the historical control group. Methods This single-center, retrospective cohort study with a historical control was performed in ACS patients undergoing PCI during 2015–2020 in a tertiary care hospital in Thailand. Primary outcomes were the usage rates of secondary prevention medications including antiplatelets, high-intensity statins, beta blockers, and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) at 3, 6, and 12 months. Secondary outcomes included all-cause rehospitalization, recurrent myocardial infarction, and death. Results Finally, there were 273 and 1,050 patients in the control and intervention groups, respectively. Baseline characteristics between the two groups were mostly similar, with a mean age of 59.44 ± 12.29 years. After adjustment for confounding factors, the usage rate of high-intensity statins was higher in the intervention group compared to the control group at 3, 6, and 12 months with adjusted odds ratios (aORs) of 2.40 (95% CI: 1.49 − 3.88), 2.01 (95% CI: 1.16 − 3.49), and 2.23 (95% CI: 1.24 − 4.00), respectively. Similarly, the usage rate of ACEIs/ARBs was consistently higher in the intervention group across all follow-up periods. Patients in the intervention group also had a lower rate of all-cause rehospitalization (adjusted hazard ratio [aHR]: 0.53; 95% CI: 0.42 − 0.67; p < 0.001) and recurrent myocardial infarction (aHR: 0.52; 95% CI: 0.28 − 0.94; p = 0.03). Conclusions The post-PCI clinic was associated with improved optimization of secondary prevention medications and favorable clinical outcomes. in ACS patients post-stenting. Although limited by its single-center, retrospective design and historical control group, this model provides a scalable framework for secondary prevention in tertiary care settings. Clinical trial number Not applicable.
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Mungkornkaew et al. (2026) conducted a cohort in Acute Coronary Syndrome post-PCI (n=1,323). Post-PCI multidisciplinary clinic vs. Usual care (historical control) was evaluated on Usage rate of high-intensity statins at 12 months (aOR 2.23, 95% CI 1.24 - 4.00). The multidisciplinary post-PCI clinic was associated with a significantly higher usage rate of high-intensity statins at 12 months compared to usual care (aOR 2.23) in post-stenting acute coronary syndrome patients.
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