Medication Use Pattern and Predictors of Optimal Therapy at Discharge in 8176 Patients With Acute Coronary Syndrome From 6 Middle Eastern Countries: Data From the Gulf Registry of Acute Coronary Events

ObjectivesThe objective was to explore the differences in medication use pattern of lipid-lowering drug (LLD) and antiplatelet agents among post-percutaneous coronary intervention patients with acute coronary syndrome aged <65 in Hong Kong (HK) and the USA.DesignRetrospective study.SettingThis study used deidentified claims data from Clinformatics Data Mart database (OptumInsight, Eden Prairie, Minnesota, USA) and electronic health records from HK Hospital Authority Clinical Data Analysis and Reporting System database.ParticipantsWe used 1 year prescription records of LLDs and antiplatelet agents among 1013 USA patients and 270 HK Chinese patients in 2011–2013.Primary and secondary outcome measuresContinuity was investigated on the assumption that one defined daily dose represented 1 day treatment. Medication possession ratio method was used to evaluate the adherence. Multivariate-adjusted logistic regressions were constructed to compare the good continuity and adherence levels in the merged database with the cutoffs set at 80%, and Cox proportional hazard models were built using the time to discontinuation as the dependent variable, to assess the persistence level.ResultsHK Chinese patients were less adherent (67.41% vs 84.60%, adjusted odds ratio (AOR) for Americans over Chinese=2.23 (95% CI=1.60 to 3.12), p<0.001) to antiplatelet agents compared with American patients but better adherent to statins (90.00% vs 78.18%, AOR=0.37 (0.23 to 0.58), p<0.001). The discontinuation with statins was more common in American patients (13.33% vs 34.25%, adjusted hazard ratio (AHR)=2.95 (2.05 to 4.24), p<0.001). Low-to-moderate potency statins and clopidogrel were favoured by our HK local physicians, while American patients received higher doses of statins and prasugrel.ConclusionsWe seemed to find HK physicians tended to prescribe cheaper and lower doses of statins and antiplatelet agents when compared with the privately insured patients in the USA, though the adherence and persistence levels of HK patients with statins were relatively good.

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The Prevalence and Outcome of Excess Body Weight Among Middle Eastern Patients Presenting With Acute Coronary Syndrome

Angiology ◽

10.1177/0003319709355801 ◽

2009 ◽

Vol 61 (5) ◽

pp. 456-464 ◽

Cited By ~ 8

Author(s):

Hadi A. R. Hadi ◽

Mohammad Zubaid ◽

Wael Al Mahmeed ◽

Ayman A. El-Menyar ◽

Alawi A. Alsheikh-Ali ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Body Weight ◽

Middle Eastern ◽

Excess Body Weight ◽

Coronary Syndrome

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Six-month mortality rates are lower in patients with an acute coronary syndrome treated with the combination of clopidogrel and a statin than in patients treated with either therapy alone: An analysis from the global registry of acute coronary events

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)82130-7 ◽

2003 ◽

Vol 41 (6) ◽

pp. 361

Author(s):

Michael J Lim ◽

Frederick A Spencer ◽

Joel M Gore ◽

Omar H Dabbous ◽

Eva M Kline-Rogers ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Mortality Rates ◽

Coronary Syndrome ◽

Coronary Events ◽

Global Registry

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Faculty Opinions recommendation of High-Frequency Biomarker Measurements of Troponin, NT-proBNP, and C-Reactive Protein for Prediction of New Coronary Events After Acute Coronary Syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739665911.793583478 ◽

2021 ◽

Author(s):

Alan Maisel

Keyword(s):

Acute Coronary Syndrome ◽

High Frequency ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome ◽

Coronary Events

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High Dose Statins: Is it Beneficial over Conventional Dose of Statin in Acute Coronary Syndrome?

Cardiovascular Journal ◽

10.3329/cardio.v2i2.6648 ◽

1970 ◽

Vol 2 (2) ◽

pp. 245-251

Author(s):

AEM M Islam ◽

AAS Mazumder

Keyword(s):

Acute Coronary Syndrome ◽

Heart Disease ◽

Statin Therapy ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Surgical Care ◽

High Dose ◽

Coronary Syndrome ◽

Conventional Dose ◽

Coronary Events

Increasing burden of cardiovascular disease risk factors has led to increase in the incidence in the coronary artery disease (CAD). Advancements in medical and surgical care of patients with heart disease have led to a large number of people surviving acute coronary events. Patients with acute coronary syndrome (ACS) are at high risk for recurrent coronary events, sudden death, and all cause mortality. Conventional revascularization therapies reduce the risk of further ischaemia but do not affect the underlying atherosclerotic disease. Statins have a proven record in the secondary prevention of coronary heart disease. Furthermore, statins have been shown to exert various pleotropic effects, which may stabilize vulnerable atherosclerotic plaques. Therefore, initiating, statin therapy in patients with established CAD is both beneficial and more cost effective. Trials conducted in recent times have addressed the issue of whether higher dose statin therapy provides further reductions in the risks of cardiovascular events following an acute coronary syndrome diagnosis, over and above that provided by a conventional dose statin regimen. However, recent trials of high dose statin therapy in patients with acute coronary syndromes have yielded conflicting results. The aim of this article is to provide a critical and up-to-date summary of the findings of clinical trials of intensive statin therapy, including a brief overview of safety and efficacy of such treatments. Keywords: Statin; Acute coronary syndrome. DOI: 10.3329/cardio.v2i2.6648Cardiovasc. j. 2010; 2(2) : 245-251

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