title: [SECONDARY PREVENTION IN PATIENTS WITH ACUTE CORONARY SYNDROME HOSPITALIZED IN INTERNAL MEDICINE DEPARTMENTS].
abstract: BACKGROUND
  Secondary prevention treatment with aspirin/ clopidogrel, beta blockers, inhibitors of the rennin-angiotensin-aldosterone converting system and statins reduces the morbidity and mortality of patients after acute coronary syndrome (ACS). However, clinical experience suggests that prescription rates in patients hospitalized in internal medicine departments may be low.
  
  
  OBJECTIVE
  To determine the rate of administration of secondary prevention in ACS patients hospitalized in internal medicine departments; identify predictors for full regimen use and evaluate reasons for non-prescription of the medications.
  
  
  METHODS
  Retrospective review of the files of 399 patients with ACS hospitalized in the 5 departments of internal medicine in a university affiliated medical center in 2010. Data were collected on demographic and clinical parameters, findings on current admission, medications at admission and at discharge, and reasons for nonprescription of secondary preventive medications.
  
  
  RESULTS
  Overall, 62% of patients were discharged with full secondary preventive treatment. In the remainder, the reason for not prescribing the medications was usually not specified. Factors associated with prescription of the "full regimen" were patient receipt of full secondary prevention treatment prior to admission, hypertension, history of myocardial infarction and revascularization, non-ST elevation myocardial infarction as the reason for the current admission, and performance of percutaneous coronary intervention during the current hospitalization. Atrial fibrillation was a negative predictor.
  
  
  CONCLUSIONS
  The prescription of full secondary prevention treatment in ACS patients hospitalized in internal medicine departments is suboptimal. Further efforts are needed to implement comprehensive guideline-based management.
authors.forename: Doha Haj
authors.initials: DH
authors.lastname: Yahia
authors.forename: David
authors.initials: D
authors.lastname: Pereg
authors.forename: Michael
authors.initials: M
authors.lastname: Lishner
authors.forename: Avishay
authors.initials: A
authors.lastname: Elis
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000209:etiology; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data; D000077144:Clopidogrel; D005260:Female; D006748:Hospital Departments / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007557:Israel / Q000453:epidemiology; D008297:Male; D054539:Medication Therapy Management / Q000592:standards; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin