Frequency of Use of Statins and Aspirin in Patients With Previous Coronary Artery Bypass Grafting

Curl, Kevin; LeBude, Bryan; Ruggiero, Nicholas J.; Fischman, David L.; Rose, Andrew; Patel, Sulay; Ogilby, David; Walinsky, Paul; Jasti, Babu; Savage, Michael P.

doi:10.1016/j.amjcard.2016.04.006

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Perhaps more medication education was delivered in the out-patient clinics than in the cardiac wards in Iraq, but with less variation in Australia. The study findings highlight the importance of patient education and medication related knowledge to enhance adherence behaviour in cardiac ward before patient discharge, in out-patient clinics and cardiac rehabilitation settings (Curl et al, 2016). Iraqi patients with CVD might have experienced particular problems in accessing quality health services due to the lack of or limited resources which might include provision of medications in public hospitals.…”

Section: Factors Associated With Medication Adherencementioning

confidence: 92%

Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq

et al. 2019

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Background: Adherence to cardiac medication regimes is essential for effective treatment of cardiovascular disease but is unsatisfactory in Australia and little studied in Iraq. Aim: This study evaluated and compared adherence to cardiac medications and potentially predictive factors based on the Theory of Planned Behaviour (TPB) in patients with cardiovascular disease admitted to hospital and attending cardiac services in Australia and Iraq. Methods: A cross-sectional multi-centre comparative study involving 246 cardiac patients was conducted in Australia (one hospital in Sydney) and Iraq (three cardiac hospitals in Baghdad) between October 2016 and December 2017. Adherence to medications and related factors were examined using established, validated questionnaires, formally translated and validated into Arabic for Iraqi participants. Binary logistic regression was conducted to determine those factors independently predictive of cardiac medication adherence, in Australia and Iraq. Findings: A significantly higher proportion (64.3%) of Iraqi than Australian (37.5%) cardiac patients reported medium/low levels of adherence to their cardiac medications. After adjusting for confounding factors, the ability to correctly self-administer and refill medications, and beliefs about cardio-protective medication were identified as independent predictors of cardiac medication adherence behaviour in both Australian and Iraqi participants. In Iraq, patients recruited from outpatient cardiac clinics were significantly more likely to report adherent behaviours than patients recruited as in-patients of the cardiac ward. Conclusion: Non-adherence to cardiac medications differed but was sub-optimal in both Australian and Iraqi patient samples, in both countries, adherence was associated with patients' beliefs about medications, and ability to self-administer and refill medications. Clinical nurses and pharmacists need to investigate these factors at every point in the cardiac trajectory to optimise medication adherence.

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Section: Factors Associated With Medication Adherencementioning

confidence: 92%

Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq

et al. 2019

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“…However, there remains a need to study the effects of statin therapy in the long-term follow-up following myocardial revascularization [18]. Inadequate dosing and suboptimal adherence to statin therapy in managing patients after myocardial revascularization are issues still to be solved [19].…”

Section: Resultsmentioning

confidence: 99%

The Role of Basic Pharmacotherapy in the Prevention of Late Adverse Events After Elective Coronary Artery Bypass Grafting

et al. 2020

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The aim: To determine the role of adherence to the guidelines on basic pharmacotherapy in prevention of late major adverse clinical events (MAEs) in patients with stable CAD for three years following isolated CABG. Materials and methods: A prospective single-centre study included 251 consecutive patients with stable CAD (mean age (61±9) years, 218 (86.9%) males), after isolated CABG. In three years MAЕs occurred in 55 (21.9%) patients. The data on pharmacotherapy at follow-up were obtained in 250 patients: 196 (78.4%) patients without MAEs (at scheduled visit) and 54 (21.6%) patients with MAEs (based on in-hospital or archive data). Results: Basic CAD pharmacotherapy after CABG was comparable in MAEs vs. no-MAEs groups, with the vast majority of patients receiving guideline-recommended therapy with angiotensin-converting enzyme inhibitors (ACEII) or angiotensin-II receptors blockers (ARBs), statins and antiplatelet drugs. At three years follow-up, MAEs group, as opposed to no-MAEs group, was characterized by the lower usage of ACEII/ARBs (68.5% vs. 87.2%, respectively; p=0,001) and statins (59.3% vs. 86.7%, respectively; p<0,001), as well as basic triple therapy (ACEII or ARBs/statins/antiplatelet drugs: 35.2% vs. 70.4%, respectively [p<0,001]). Conclusions: At three – year follow-up MAEs in patients with stable CAD after CABG were associated with more frequent discontinuation of previously prescribed basic pharmacotherapy, namely ACEII/ARBs and statins, as well as triple therapy (ACEII/ARBs, statins and antiplatelet drugs).

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“…The problem of statin under-utilization is widespread, including in those with secondary prevention indications for statin therapy. While high-intensity statins are recommended for all patients with CAD, multiple studies in patients with prior known CAD have shown only 55%-77% were on any statin therapy [29][30][31]. It has been shown that the detection of CAC is an effective motivator for patients to improve their lifestyle and improve compliance with CV preventive therapies, such as aspirin and statins [32,33].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Coronary Artery Calcification on Pre-Atrial Fibrillation Ablation CT Pulmonary Venograms and its Impact on Selection for Statin Therapy

Dunleavy

Guha

Cardona

et al. 2020

JCM

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Atherosclerotic cardiovascular disease (ASCVD) shares many risk factors with atrial fibrillation (AF). Obtaining computed tomography images of the pulmonary veins (CTPV) before AF ablation procedures is common and can incidentally detect coronary artery calcification (CAC). The purpose of this study was to investigate the prevalence of CAC on pre-ablation CTPV, the frequency of CAC reporting on CTPV reports, and its impact on statin therapy among patients hospitalized for AF procedures. We retrospectively evaluated consecutive patients undergoing CTPV and AF procedures from October 2016 to December 2017 in a single-center tertiary hospital. The patients’ demographic and clinical characteristics were analyzed. The CAC presence on CTPV was visually assessed. The severity was classified qualitatively. The statin therapy status was evaluated using the patient’s admission and discharge medication lists. A total of 638 subjects were included in our study, with 34.5% female. The mean age was 63.3 ± 10.8 years. CAC was detected in 70.1% of all patients, and in 58.1% of patients without a history of ASCVD. When present, CAC was documented in 92.6% of the clinical CTPV reports. While coronary artery atherosclerosis was present in a majority of AF patients, and its presence was widely reported, it was not associated with increased statin therapy at discharge.

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Frequency of Use of Statins and Aspirin in Patients With Previous Coronary Artery Bypass Grafting

Cited by 9 publications

References 18 publications

Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq

Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq

The Role of Basic Pharmacotherapy in the Prevention of Late Adverse Events After Elective Coronary Artery Bypass Grafting

Prevalence of Coronary Artery Calcification on Pre-Atrial Fibrillation Ablation CT Pulmonary Venograms and its Impact on Selection for Statin Therapy

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