title: Self-reported use of complementary and alternative medicine in patients with previous acute coronary syndrome.
abstract: Complementary and alternative medicine (CAM) use is common in patients with cardiovascular disease. Although numerous efforts have sought to understand CAM types and the prevalence of CAM, whether patients preferentially use CAM instead of evidence-based therapies is unknown. Self-reported use of CAM and evidence-based therapies in a prospective registry of hospitalized patients with acute coronary syndrome from March 1, 2001 to October 31, 2002 were examined. Poisson regression models were used to assess whether CAM use was independently associated with lower rates of aspirin, beta-blocker, and statin use in 596 patients with established coronary artery disease (CAD). Overall, CAM use was 19% in patients with CAD. Higher proportions of patients who used CAM were non-Caucasian (31% vs 12%), uninsured (12% vs 7%), economically burdened (58% vs 29%), and had depression (13% vs 6%, p<0.05 for all). Patients who used CAM were more likely to use beta blockers (64% vs 46%, p=0.008) and as likely to use aspirin (73% vs 74%, p=0.90) and statins (71% vs 68%, p=0.76) as non-CAM users. Adjusting for demographic and clinical factors did not change results (CAM users: RR 1.27, 95% confidence interval [CI] 1.01 to 1.60 for using beta blockers, RR 0.97, 95% CI 0.85 to 1.11 for using aspirin, and RR 1.05, 95% CI 0.87 to 1.28 for using statins). In conclusion, although CAM users with established CAD have worse socioeconomic status than nonusers, we found no evidence that they were less compliant with evidence-based therapies.
authors.affiliation: Mid America Heart Institute of Saint Lukes Hospital, and School of Nursing, University of Missouri-Kansas City, Kansas City, Missouri, USA. cldecker@saint-lukes.org
authors.forename: Carole
authors.initials: C
authors.lastname: Decker
authors.forename: Jason
authors.initials: J
authors.lastname: Huddleston
authors.forename: Mikhail
authors.initials: M
authors.lastname: Kosiborod
authors.forename: Donna M
authors.initials: DM
authors.lastname: Buchanan
authors.forename: Casey
authors.initials: C
authors.lastname: Stoner
authors.forename: Angela
authors.initials: A
authors.lastname: Jones
authors.forename: Sudeshna
authors.initials: S
authors.lastname: Banerjee
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000704:Analysis of Variance; D000789:Angina, Unstable / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009203:Myocardial Infarction / Q000628:therapy; D016012:Poisson Distribution; D011446:Prospective Studies; D012042:Registries; D012044:Regression Analysis; D012107:Research Design; D012650:Self Disclosure; D012959:Socioeconomic Factors; D013577:Syndrome
chemical_list: D000319:Adrenergic beta-Antagonists; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin