Recent hospitalization for Non-coronary events and use of preventive medications for coronary artery disease: An observational cohort study

BMC Cardiovascular Disorders

Research Article

Steven M Bradley¹  Charles Maynard¹  Stephan D Fihn¹  Chris L Bryson¹  Thomas M Maddox² 

[1] Health Services Research & Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, and University of Washington, Seattle, WA, USA;VA Eastern Colorado Health Care System and University of Colorado Denver, Denver, CO, USA;

关键词: Acute Coronary Syndrome;    Veteran Affair;    Preventive Care;    Coronary Artery Disease Patient;    Index Event;   

DOI  :  10.1186/1471-2261-11-42

 received in 2010-11-24, accepted in 2011-07-09,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHigh-quality systems have adopted a comprehensive approach to preventive care instead of diagnosis or procedure driven care. The current emphasis on prescribing medications to prevent complications of coronary artery disease (CAD) at discharge following an acute coronary syndrome (ACS) may exclude high-risk patients who are hospitalized with conditions other than ACS.MethodsAmong a sample of patients with CAD treated at Veterans Affairs medical centers between January, 2005 and November, 2006, we investigated whether recent non-ACS hospitalization was associated with prescriptions of preventive medications as compared with patients recently hospitalized with ACS.ResultsOf 13,211 patients with CAD, 58% received aspirin, 70% β-blocker, 60% angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB), and 65% lipid-lowering therapy. Twenty-five percent of eligible patients were receiving all four medications. Having been hospitalized for a non-ACS event in the prior 6 months did not substantially affect the adjusted proportion on preventive medications. In contrast, among patients hospitalized for ACS in the prior 6 months, the adjusted proportion prescribed aspirin was 21% higher (p < 0.001), β-blocker was 14% higher (p < 0.001), ACE-I or ARB was 9% higher (p < 0.001), lipid therapy was 12% higher (p < 0.001), and prescribed all four medications was 18% higher (p < 0.001) than among patients hospitalized for ACS more than 2 years earlier.ConclusionsBeing hospitalized for a non-ACS condition did not appear to influence preventive medication use among patients with CAD and represents a missed opportunity to improve patient care. The same protocols employed to improve use of preventive medications in patients discharged for ACS might be extended to CAD patients discharged for other conditions as well.

【 授权许可】

CC BY   
© Bradley et al; licensee BioMed Central Ltd. 2011