title: Use of medicines recommended for secondary prevention of acute coronary syndrome.
abstract: OBJECTIVE
  To analyze if the demographic and socioeconomic variables, as well as percutaneous coronary intervention are associated with the use of medicines for secondary prevention of acute coronary syndrome.
  
  
  METHODS
  In this cohort study, we included 138 patients with acute coronary syndrome, aged 30 years or more and of both sexes. The data were collected at the time of hospital discharge, and after six and twelve months. The outcome of the study was the simultaneous use of medicines recommended for secondary prevention of acute coronary syndrome: platelet antiaggregant, beta-blockers, statins and angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker. The independent variables were: sex, age, education in years of attending, monthly income in tertiles and percutaneous coronary intervention. We described the prevalence of use of each group of medicines with their 95% confidence intervals, as well as the simultaneous use of the four medicines, in all analyzed periods. In the crude analysis, we verified the outcome with the independent variables for each period through the Chi-square test. The adjusted analysis was carried out using Poisson Regression.
  
  
  RESULTS
  More than a third of patients (36.2%; 95%CI 28.2;44.3) had the four medicines prescribed at the same time, at the moment of discharge. We did not observe any differences in the prevalence of use in comparison with the two follow-up periods. The most prescribed class of medicines during discharge was platelet antiaggregant (91.3%). In the crude analysis, the demographic and socioeconomic variables were not associated to the outcome in any of the three periods.
  
  
  CONCLUSIONS
  The prevalence of simultaneous use of medicines at discharge and in the follow-ups pointed to the under-utilization of this therapy in clinical practice. Intervention strategies are needed to improve the quality of care given to patients that extend beyond the hospital discharge, a critical point of transition in care.
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Mari Ângela
authors.initials: MÂ
authors.lastname: Gaedke
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Juvenal Soares Dias da
authors.initials: JS
authors.lastname: Costa
authors.affiliation: Instituto de Medicina Vascular, Hospital Mãe de Deus, Porto Alegre, RS, Brasil.
authors.forename: Euler Roberto Fernandes
authors.initials: ER
authors.lastname: Manenti
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Ruth Liane
authors.initials: RL
authors.lastname: Henn
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Vera Maria Vieira
authors.initials: VM
authors.lastname: Paniz
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Marcelo Felipe
authors.initials: MF
authors.lastname: Nunes
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Monique Adriane da
authors.initials: MA
authors.lastname: Motta
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
authors.forename: Maria Teresa Anselmo
authors.initials: MT
authors.lastname: Olinto
mesh_terms: D054058:Acute Coronary Syndrome / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D001938:Brazil; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000145:classification; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention
chemical_list: D002317:Cardiovascular Agents