Adherence to clinical practice guidelines and use of secondary cardiovascular prevention medications in Middle Eastern patients undergoing percutaneous coronary intervention: Results from The First Jordanian PCI Registry (JoPCR1)

Ayman Hammoudeh, Haneen Kharabsheh, Yousef Khader, Ramzi Tabbalat, Imad Alhaddad, Assem Nammas, Mahmoud Izraiq, Eyas Al-Mousa, Akram Saleh

Abstract


Background. Adherence to guidelines-recommended secondary cardiovascular (CV) prevention therapies has not been adequately studied in Middle Eastern patients undergoing percutaneous coronary interventions (PCI) for acute coronary syndrome (ACS) or stable coronary disease (SC). The First Jordanian PCI Registry (JoPCR1) is a prospective multicenter study that evaluated the adherence to guidelines and use of evidence-based therapies in a large PCI population.
Methods. Consecutive patients undergoing PCI in 12 tertiary care centers in Jordan were included in this analysis. Baseline clinical features and laboratory data were evaluated at admission. Use of recommended CV medications was evaluated on admission and at 1 year.
Results. 2426 consecutive patients undergoing PCI from January 2013 to February 2014 were enrolled. PCI was indicated for ACS (N=1870, 77.1%) or SC (N=556, 22.9%). Dual antiplatelet therapy was administered for 99.1% and 96.8% of patients during hospitalization and at one year; respectively. Prescription of recommended CV medications during index hospitalization included beta blockers (74.8%), renin angiotensin aldosterone system blockers (57.1%), and statins (94.2%). At one year, these medications were used in 74.3%, 57.2%, and 92.3%; respectively. Five high risk groups were defined: women (N=500, 21%), patients older than 60 years of age (N=1013, 42%), diabetic patients (N=1300, 54%), overweight, i.e., body mass index >25 kg/m2 (N=1877, 77%) and patients who developed heart failure during hospitalization (N=194, 8%). No significant underuse of the secondary CV prevention medications in these groups was observed during index admission or at one year.
Conclusions. In this first large Middle Eastern PCI registry; adherence to the use of evidence-based secondary CV preventive medications during hospitalization and at one year was remarkably high and comparable to other regions in the world. There was no underutilization of these medications in high risk groups.

Keywords


Adherence to guidelines, Percutaneous coronary intervention, Cardiovascular disease in the Middle East.

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