Jari Heiskanen1,2,3, Juha Hartikainen1,4, Janne Martikainen3, Heikki Miettinen1, Mikko Hippeläinen1, Risto P Roine2,5,6,7, Anna-Maija Tolppanen8,9. 1. Heart Center, Kuopio University Hospital, Kuopio, Finland. 2. Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland. 3. School of Pharmacy, University of Eastern Finland, P.O. Box 1627, Yliopistonranta 1 C, FI-70211, Kuopio, Finland. 4. School of Medicine, University of Eastern Finland, Kuopio, Finland. 5. Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland. 6. Kuopio University hospital, Kuopio, Finland. 7. Helsinki University Hospital, Helsinki, Finland. 8. Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland. anna-maija.tolppanen@uef.fi. 9. School of Pharmacy, University of Eastern Finland, P.O. Box 1627, Yliopistonranta 1 C, FI-70211, Kuopio, Finland. anna-maija.tolppanen@uef.fi.
Abstract
AIMS: We studied the purchases of medical therapy recommended for coronary artery disease patients before and after elective revascularisation (percutaneous coronary intervention (PCI) or coronary bypass grafting (CABG)). METHODS: All patients who underwent an elective PCI (N = 1557) or CABG (N = 1768) at the Heart Center, Kuopio University hospital between 2007 and 2014 were included. Data were collected from the hospital's coronary register and national registers, and obtained for 3 years before and 1 year after the revascularisation. RESULTS: Altogether 85.2% of PCI patients and 88.1% of CABG patients had purchased lipid-modifying agents before the procedure, and 94.9% and 96.8% during the post-procedure follow-up year, respectively. Beta-blocking agents were purchased by 84.9% of PCI patients before and by 87.9% after the procedure and by 86.3% of CABG patients before and 97.1% after the operation. Of PCI patients, 64.3% had purchased organic long-acting nitrates before the procedure and 54.4% also after the procedure. Among CABG patients, the purchase of organic long-acting nitrates fell from 59.7% before to 10.1% after the operation. The use of ADP receptor blocking agents increased in PCI patients (26.3 to 83.9%) and the use of warfarin in CABG patients (9.4 to 21.3%). Medication purchases were more common among those who had greater use of hospital services before and after the procedures. CONCLUSIONS: In both PCI and CABG patients, the use of medical therapy before and after revascularisation procedure complied with current guidelines. Purchases of long-acting nitrates were common in the PCI group even after the procedure.
AIMS: We studied the purchases of medical therapy recommended for coronary artery diseasepatients before and after elective revascularisation (percutaneous coronary intervention (PCI) or coronary bypass grafting (CABG)). METHODS: All patients who underwent an elective PCI (N = 1557) or CABG (N = 1768) at the Heart Center, Kuopio University hospital between 2007 and 2014 were included. Data were collected from the hospital's coronary register and national registers, and obtained for 3 years before and 1 year after the revascularisation. RESULTS: Altogether 85.2% of PCI patients and 88.1% of CABG patients had purchased lipid-modifying agents before the procedure, and 94.9% and 96.8% during the post-procedure follow-up year, respectively. Beta-blocking agents were purchased by 84.9% of PCI patients before and by 87.9% after the procedure and by 86.3% of CABG patients before and 97.1% after the operation. Of PCI patients, 64.3% had purchased organic long-acting nitrates before the procedure and 54.4% also after the procedure. Among CABG patients, the purchase of organic long-acting nitrates fell from 59.7% before to 10.1% after the operation. The use of ADP receptor blocking agents increased in PCI patients (26.3 to 83.9%) and the use of warfarin in CABG patients (9.4 to 21.3%). Medication purchases were more common among those who had greater use of hospital services before and after the procedures. CONCLUSIONS: In both PCI and CABG patients, the use of medical therapy before and after revascularisation procedure complied with current guidelines. Purchases of long-acting nitrates were common in the PCI group even after the procedure.
Entities:
Keywords:
Coronary disease; Evidence-based medicine; Healthcare; Medical research; Optimal medical therapy; Public health; Revascularisation
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