Frequency and Reasons for Non-Administration and Suspension of Drugs During an Acute Coronary Syndrome Event. The ERICO Study

Author(s)

Rafael C. O. Santos ^[1] ; Isabela M. Bensenor ; Alessandra C. Goulart ^[3] ; Paulo A. Lotufo ; Itamar S. Santos

Affiliation

^[1] Universidade de São Paulo. Hospital Universitário da USP. Centro de Pesquisa Clínica e Epidemiológica - Brasil

^[3] Universidade de São Paulo. Hospital Universitário da USP. Centro de Pesquisa Clínica e Epidemiológica - Brasil

• Document type: Journal article
• Source: Arquivos Brasileiros de Cardiologia; v. 115, n. 5, p. 830-839, 2020-12-07.

Abstract

Abstract Background: Few studies have discussed the reasons for pharmacological undertreatment of Acute Coronary Syndrome (ACS). Objectives: To determine the frequency and reasons for the non-administration and suspension of medications during in-hospital treatments of ACS in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: The present study analyzed the medical charts of the 563 participants in the ERICO study to evaluate the frequency and reasons for the non-administration and/or suspension of medications. Logistic regression models were built to analyze if sex, age ≥65 years of age, educational level, or ACS subtype were associated with (a) the non-administration of ≥1 medications; and (b) the non-administration or suspension of ≥1 medications. The significance level was set at 5%. Results: This study's sample included 58.1% males, with a median of 62 years of age. In 183 (32.5%) participants, ≥1 medications were not administered, while in 288 (51.2%), ≥1 medications were not administered or were suspended. The most common reasons were the risk of bleeding (aspirin, clopidogrel, and heparin), heart failure (beta blockers), and hypotension (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers). Individuals aged ≥65 (odds ratio [OR]:1.51; 95% confidence interval [95% CI]:1.05-2.19) and those with unstable angina (OR:1.72; 95% CI:1.07-2.75) showed a higher probability for the non-administration of ≥1 medication. Considering only patients with myocardial infarction, being ≥65 years of age was associated with both the non-administration and the non-administration or suspension of ≥1 medication. Conclusions: Non-administration or suspension of ≥1 medication proved to be common in this ERICO study. Individuals of ≥65 years of age or with unstable angina showed a higher probability of the non-administration of ≥1 medication and may be undertreated in this scenario. (Arq Bras Cardiol. 2020; 115(5):830-839) (AU)

• FAPESP's process: 11/16301-4 - Evaluation of individuals with acute coronary syndromes treated in the University Hospital of the University of São Paulo according to the first-contact health care unit
• Grantee: Itamar de Souza Santos
• Support Opportunities: Regular Research Grants