[Prescription of platelet antiaggregants in secondary prevention of ischemic heart disease].
OBJECTIVE
To find out how many patients older than 64 years of age seen in a primary health care (PHC) centre receive antiplatelet drugs for secondary prevention of coronary heart disease (CHD), as well as by whom they are prescribed, which drug is chosen, and what are its contraindications, unwanted effects and motives for ending therapy.


METHODS
Description of all cases of CHD among patients older than 64, identified through the audit of clinical records.


METHODS
Urban health care centre with 23,702 inhabitants, with 2,742 over 64, 2,660 of whom have clinical records.


METHODS
Patients over 64 with CHD, seen in the health centre within 1993.


METHODS
Age, sex, type of CHD, therapy with a platelet aggregation inhibitor, drug used, dose, prescriptor, adverse events, contraindications.


RESULTS
We identified 179 cases of CHD, a prevalence of 6.7%, of which 60.9% were male. 94 patients received an antiplatelet drug: aspirin (88.3%), dypiridamol and triflusal (5.3% each) and ticlopidine (1 case). 111 patients were adequately treated, including 84 given aspirin or ticlopidine, 12 patients in which therapy was ended due to adverse events, and 15 patients in which use of antiaggregant drugs was contraindicated. All prescriptions originating from general practitioners were for aspirin, while specialists prescribed other drugs in 11% of cases.


CONCLUSIONS
Two-thirds of patients with CHD were correctly treated. Aspirin is the antiaggregant drug most frequently used, particularly among PHC physicians. Even low doses of aspirin were associated with interruptions of therapy due to adverse events.
Calpe Climent
A V
AV
Centro de Salud Camp Redó, Atención Primaria de Mallorca, Insalud Baleares.
Tomàs Arbona
F J
FJ
Horrach Pérez
M
M
Peña Díaz
J J
JJ
Llobera C-anaves
J
J
Thomàs Mulet
V
V
Rodríguez Moreno
C
C
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D004176:Dipyridamole / Q000627:therapeutic use; D011307:Drug Prescriptions; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008511:Medicine; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015995:Prevalence; D011320:Primary Health Care; D012459:Salicylates / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology; D013038:Specialization; D013988:Ticlopidine / Q000627:therapeutic use; D014505:Urban Population
D010975:Platelet Aggregation Inhibitors; D012459:Salicylates; C016167:triflusal; D004176:Dipyridamole; D013988:Ticlopidine; D001241:Aspirin
Prescripción de antiagregantes plaquetarios en la prevención secundaria de la cardiopatía isquémica.