Background: Cardiovascular disease, especially coronary disease, represents one of the main causes of morbidity and mortality. Objective: To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event. Methods: Cross-sectional study. We included adult patients of any sex affiliated with one healthcare insurer of the Colombian Health System, with a diagnosis of a first episode of acute coronary syndrome that occurred during the period of 2015 to 2016. Sociodemographic, clinical and pharmacological variables were evaluated from clinical records. The cardiovascular risk score prior to the event was calculated, and the need for the use of statins and aspirin in primary prevention was defined according to the recommendations of clinical practice guidelines. Results: Clinical records of 322 patients were reviewed with mean age of 61.9 ± 10.8 years, and 77.3% were men. The most frequent comorbidities were dyslipidemia (64.3%), arterial hypertension (62.7%) and diabetes mellitus (30.1%); 22% of the patients were obese, and 33.5% were smokers. The cardiovascular risk score was calculated in 211 patients (65.5%) who had the necessary variables complete. The median 10-year risk according to Framingham risk score was 21.4%, and it was 16.3% according to the American Heart Association. From the 211 patients with risk scores, there were 179 (84.8%) who needed statins (175 of high intensity, 97.8%), and 88 (27.3%) required aspirin as a primary prevention; however, 56 of these patients (31.3%) did not receive any statins, 127 (72.6%) did not receive the high intensity statin they needed, and 38 (43.2% of those with indication) lacked aspirin. Conclusion: Real-life data show that among a group of patients with high cardiovascular risk, a substantial proportion were not receiving medications for primary prevention necessary to reduce their risk and finally suffered an acute coronary event.

To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event.Cross-sectional study from patients with a diagnosis of a first episode of acute coronary syndrome. We included patients affiliated with one healthcare insurer of the Colombian Health System, of any sex and age, with a diagnosis of a first episode of acute coronary syndrome that occurred during the period of 2015 to 2016. Sociodemographic, clinical and pharmacological variables were evaluated from clinical records. The cardiovascular risk score prior to the event was calculated, and the need for the use of statins and aspirin in primary prevention was defined according to the recommendations of clinical practice guidelines. Clinical records of 322 patients were reviewed with mean age of 61.9±10.8 years, and 77.3% were men. The most frequent comorbidities were dyslipidemia (64.3%), arterial hypertension (62.7%) and diabetes mellitus (30.1%); 22% of the patients were obese, and 33.5% were smokers. The median 10-year risk according to Framingham risk score was 21.4%, and it was 16.3% according to the American Heart Association. There were 179 patients (84.8%) who needed statins (175 of high intensity, 97.8%), and 88 (27.3%) required aspirin as a primary prevention; however, 56 of these patients (31.3%) did not receive any statins, 127 (72.6%) did not receive the high intensity statin they needed, and 38 (43.2%) lacked aspirin. Real-life data show that among a group of patients with high cardiovascular risk, a substantial proportion were not receiving medications for primary prevention necessary to reduce their risk and finally suffered an acute coronary event.

measured using the medication possession ratio (MPR). Methods: A retrospective analysis was conducted using data from a large private health insurance claims database, years 2007-2014. Subjects were included based on having at least 2 hypertension diagnosis and having filled an antihypertensive prescription (N=595,056). The date of the first fill is the subject's index date, and subjects were required to have at least 6 months of data in the pre-index and 12 months post-index. MPR was calculated for the duration of therapy. Health related expenditures were calculated for both the pre and post periods, in terms of pharmacy, inpatient, medical, and total costs. Covariates of interest included age, gender, health insurance type, geographic region, comorbidities, and previous 6 months total health expenditures. Analyses on costs utilized generalized linear models (GLM) and 2-part regression models. Analyses for time to event outcomes will utilize Cox survival models. Results: Descriptively, 53% of the population is male, 80% of the population is under 65, 58% had a point-of-service health plan, 38% had an MPR of 1, and 14% an MPR less than 0.05. Preliminary analyses indicate that a higher MPR correlates with higher pharmacy costs