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Use of secondary preventive drugs depends on revascularization method
Patients who underwent CABG were generally less likely than patients who received PCI to fill prescriptions for secondary preventive medications and to use those medications consistently in the first year after the procedure, results from a recent study have shown.
In the study, researchers used data from the health plan databases of a large, integrated health care delivery system to identify patients who never filled a prescription and to calculate the medication possession ratio (defined as a percentage of the year for which the patient had continuous use of the prescription) among patients who filled at least one prescription.
In all, 8,837 patients with new onset coronary disease underwent initial CABG, and 14,516 underwent initial PCI from 2000 to 2007.
Most patients received a statin in the first year after any coronary revascularization. Patients receiving CABG were more likely than those receiving PCI to not fill the prescription for a statin (7.1% vs. 4.8%; P<.0001) or an ACE inhibitor/angiotensin receptor blockers (29.1% vs. 22.4%; P<.0001).
Most patients were treated with a beta-blocker after coronary revascularization, and proportions between the two types of procedures were similar for never having filled a prescription for this drug class (6.4% vs. 6.1%).
Among those who filled at least one prescription, patients receiving CABG had lower medication possession ratios than patients receiving PCI for ACE inhibitor/angiotensin receptor blockers (69.4% vs. 77.8%; P<.0001), beta-blockers (76.1% vs. 80.6%; P<.0001) and statins (82.7% vs. 84.2%, P<.001).
Mark A. Hlatky
“Although the absolute differences in medication use in this study were small, our findings nevertheless suggest that there might be systematic factors after CABG and PCI that contribute to lower medication use after CABG,” Mark A. Hlatky, MD, with Stanford University School of Medicine, and fellow researchers wrote. “Addressing these differences might provide an opportunity to further improve the quality of care after coronary revascularization.”
Disclosure: The researchers report no relevant financial disclosures.