Secondary prevention for coronary artery disease: are we following the guidelines?
BACKGROUND
Secondary prevention pharmacotherapy in post-myocardial infarction (MI) patients reduces the risk of subsequent coronary events and overall mortality. International guidelines recommend use of aspirin, beta-blockers, ACE inhibitors and statins in post-MI patients.


OBJECTIVE
We performed this audit to review the compliance of prescribing practices, in a regional hospital in Ireland, with international guidelines for secondary prevention of coronary artery disease.


METHODS
We performed a retrospective case review of 172 patients diagnosed with MI during a 1-year period between January and December 2007.


RESULTS
A total of 134 patients fulfilled the inclusion criteria. On discharge, aspirin was prescribed to 131 (97.76%) patients, clopidogrel to 126 (94%), beta-blockers to 117 (87%), ACE inhibitor to 87 (65%), ARB to 10 (7%) and statins to 116 (87%).


CONCLUSIONS
Our audit shows that targets for prescription of secondary prevention medications were not met in a small but significant proportion of patients and calls for review of discharge practices and education to improve compliance with guidelines.
Syed
I A A
IA
Waterford Regional Hospital, Waterford, Ireland. asimsyed01@hotmail.com
Riaz
A
A
Ryan
A
A
Reilly
M O
MO
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D055502:Secondary Prevention
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors