Assessment of proportion and prescribing trends of coronary artery diseases in a tertiary care hospital, Kerala: a prospective observational study

Authors

  • Sreelekshmi V. S. Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India
  • Philip John Sebastian Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India
  • Shamna C. Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India
  • Neenu Babu Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India
  • Nithin Manohar R. Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20205476

Keywords:

Coronary artery disease, ACCF/AHA Guidelines, Rational drug use

Abstract

Background: The aim of the study is to assess the proportion of types of coronary artery diseases and to analyze the trends of drug prescribing in coronary artery disease (CAD) by checking the compliance with the standard guidelines provided by the American College of Cardiology Foundation / American Heart Association (ACCF/AHA).

Methods: A prospective observational study was conducted in the department of Cardiology for a period of 6 months. A total of 94 patients with varied categories of CAD were screened and analyzed. Study related data was collected from case records and by a structured interview. Data analysis was done by analyzing the prescribing trends of drug and assessing the proportion of CAD.

Results: The current study found that most of the patients were of the age group of 61-70 years. The proportion of Non-ST segment elevation myocardial infarction (NSTEMI) was remarkably higher in patients with CAD (55.3%) followed by ST-elevated myocardial infarction (STEMI) (39.4%) and Unstable angina (5.3%). Chi square test shows that prescription of Antiplatelets were apparent in all the prescriptions (100%), followed by Statins (Atorvastatin 98.9%), Antihypertensives (94.7%), Anticoagulants (90.4%), Nitrates (76.6%), Antidiabetics (75.5%) and Potassium channel opener (Nicorandil 36.2%). By analyzing the prescription, it was observed that most of the drugs were prescribed rationally according to the standard treatment guidelines (ACCF/AHA).

Conclusions: This study provides an overall insight of proportion of CAD and prescribing pattern in patients with CAD which reveals the rational prescribing of drugs in accordance with the standard guidelines.

Author Biography

Sreelekshmi V. S., Department of Pharmacy Practice, Sree Krishna College of Pharmacy and Research Centre, Parassala, Trivandrum, Kerala, India

DEPATMENT OF PHAMACY PACTICE ,

PHARM.D

References

McRobbie D. Coronary heart disease. In, Roger Walker(ed). Clinical Pharmacy and Therapeutics, 5th ed. London. Elsevier. 2012;312-15.

James MR, Lionel DL, Timothy GK, Albert F. A Text book of Clinical pharmacology and Therapeutics, 5th ed. Great Britain, Hodder Arnold. 2008;196-98.

Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults, 2009. Available at https://www.ahajournals.org/doi/full/10.1161/circulationaha.109.192065. Accessed at 15 September, 2020.

Bergman U. The history of the drug utilization research group in Europe. Pharmacoepidemiol Drug Saf. 2006;15:95-8.

Cheah WL, Lee PY, Khatijah Y, Rasidah AW. A Preliminary Study on the Prevalence of Cardiovascular Disease Risk Factors in Selected Rural Communities in Samarahan and Kuching Division, Sarawak, Malaysia. Malaysian J Med Sci. 2011;18(2):59-66.

Tittu GZ, Subramanyam K, Pooja M, Vinayak JK. Drug utilization study in Ischemic heart disease in a tertiary care hospital, Mangalore, India. IJBCP. 2017;6(7):1799-1805.

Saibal M, Mitesh K Jamal Y, Vinod KG, Sanjay T. Risk factors and angiographic profile of coronary slow flow (CSF) phenomenon in North Indian population: An observational study. Indian heart journal. 2018;70:405-09.

Bandla A, Purushothama R, Yanadaiah P, Sujatha S. A study on prescribing pattern of cardiovascular drugs and potential drug –drug interaction in an inpatient cardiology unit of a cardiac care hospital at Tiruppathy. Ejpmr. 2016,3(8),294-305.

Biradar SM. Study of prescribing pattern, Identification of drug related problems and therapeutic intervention in cardiovascular diseases patients. Jddt. 2018;8(6-s):89-93.

Kamath A, Shanbhag T, Shenoy S. A Descriptive study on the influence of age and gender on drug utilization in acute myocardial infarction. Jcdr. 2010;(4):2041-2046.

Karishma A, Swopna P. Drug utilization pattern in cardiology intensive care unit in a tertiary health care institution. ijpsr. 2018;210:55.9.

Douglas PZ, Peter L, Robert OB, Eugene B. Braunwald’s Heart Disease- A Text Book of Cardiovascular Medicine, 7thed. Elsevier.

Geevar Z, Harikrishnan S, Krishnan MN. Prevalence of Coronary artery disease and risk factors in Kerala. IHJ. 2013;243-49.

Eugene B. ACC/ACH Guideline Update for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction- Summary Article. J Am Coll Cardiol. 2002;40(7):1366-74.

Brian KA. Cardiac and vascular disorders in KODA-KIMBLE & Young’s APPLIED THERAPEUTICS: The clinical use of drugs, 10th ed. Philadelphia, Lippincott Williams and wikins, Wolter Kluwer. 20009;252-436.

Krishnan MN. Prevalence of coronary artery disease and its risk factors in Kerala, South India: a community- based cross- sectional study. BMC Cardiovascular Disorders. 2016;16(12):1-12.

Abhishek S, Bhat MN. Evaluation of mortality related to acute myocardial infarction in a tertiary care centre in south India: A Descriptive study. Int J Med Health Res. 2018;4(12):48-52.

Battu R, Suresh BS, Jaladi H, Emilda TJ, Angitha RV. Assessment of prescribing pattern in coronary artery disease. Int J of Allied Med Sci and Clin Research. 2016;4(4):698-715.

Pooja AC, Atul T. Study of prescription and behavior in patients with coronary heart disease about risk factors and life style modification in a tertiary care hospital, Bhavnagar. Ijcmph.2019;6(4):1549-53.

Sandeep PK. Modernizing the World Health organization List of Essential Medicines for Preventing and Controlling Cardiovascular Diseases. Journal of The American College of Cardiology. 2018;71(5):564-74.

Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India: current epidemiology and future directions.Circulation. 2016;133(16):1605-20.

Choudhary P, Agrawal JM, Maalhotra SD, Patel VJ.Drug utilization pattern in acute coronary syndrome at tertiary care hospital: a prospective cross-sectional observational study. Int J Basic Clin Pharmacl. 2016;5(2):513-6.

James C. Risk Factors for Coronary Artery Diseases: A Study Among Patients With Ischemic Heart Disease in Kerala. Heart India. 2013;1:1.

Dabbak H, Arafa MA. Risk Assessment and Risk Perception of Coronary Heart Disease in Gaza Strip, Palastine. Health. 2014;6:2883-93.

Wong ND, Nelson JC, Granston T, et al. Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the multiethnic study of atherosclerosis study. JACC Cardiovasc Imaging 2012;5:358-366.

Downloads

Published

2020-12-22

Issue

Section

Original Research Articles