Optimizing prevention and guideline-concordant care in Montenegro

Knežević, Božidarka; Musić, Ljilja; Batricevic, Goran; Bošković, Aneta; Bulatović, Nebojša; Nenezic, Ana; Vujović, Jelena; Kalezić, Milovan

doi:10.1016/j.ijcard.2016.06.218

Cited by 3 publications

(1 citation statement)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observed suboptimal prescription trends of ACEIs/ARBs post-ACS are consistent with trends seen in other parts of the world, including Qatar (ACEIs = 63.5%; ARBs = 11.3%),[ 8 ] Mid-Atlantic states (ACEIs/ARBs = 63.9%),[ 9 ] and Montenegro (ACEIs/ARBs = 72%). [ 22 ] Low prescription rates of on-discharge ACEIs/ARBs were also reported in high-risk patients according to the Global Registry of Acute Coronary Events,[ 13 ] older patients,[ 9 23 ] and individuals with comorbidities such as DM[ 12 ] and CKD. [ 24 ] In the elderly, comorbidities such as hypertension may predetermine the use of drug combinations that include ACEIs/ARBs to protect the cardiovascular and renal systems.…”

Section: Discussionmentioning

confidence: 99%

Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry

Suki,

Zuhdi,

Yahya

et al. 2024

Saudi Journal of Medicine &Amp; Medical Sciences

View full text Add to dashboard Cite

Background: Despite guideline recommendations, suboptimal prescription rates of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been observed in patients with acute coronary syndrome. Objective: This study aimed to examine the temporal trends, variations, and mortality outcomes among acute coronary syndrome patients prescribed ACEIs/ARBs in the multi-ethnic population of Malaysia. Methodology: This retrospective study utilized data from the Malaysian National Cardiovascular Disease–Acute Coronary Syndrome registry, encompassing consecutive patient records from 2008 to 2017 (N = 60,854). Ten-year temporal trends of on-discharge ACEIs/ARBs prescription were examined. Demographics, clinical characteristics and 1-year all-cause mortality outcomes were compared between patients prescribed and not prescribed ACEIs/ARBs. Results: The 10-year prescription rate of on-discharge ACEIs/ARBs was 52.8% (n = 32,140), with a significant decline over the years [linear trend test, P = 0.008; SD = 0.03; SE = 0.001; 95% CI = 0.55-0.64]. Patients aged ≥65 years (aOR = 0.79; 95% CI = 0.73–0.86) were less likely to be prescribed ACEIs/ARBs than those aged <65 years. In addition, patients with comorbid diabetes mellitus (DM) (aOR = 0.85; 95% CI = 0.79–0.92) and chronic kidney disease (CKD) (aOR = 0.34; 95% CI = 0.30–0.40) were significantly less likely to receive ACEIs/ARBs. IPW-adjusted survival analysis revealed a 38% lower 1-year all-cause mortality rate in patients prescribed on-discharge ACEIs/ARBs (HR = 0.62; 95% CI = 0.56–0.69; P < 0.001). Conclusion: Acute coronary syndrome patients with concomitant DM and CKD were less likely to receive on-discharge ACEIs/ARBs in Malaysia. Suboptimal prescription rates of ACEIs/ARBs persisted over the 10-year period, despite improved 1-year survival in ACS patients prescribed ACEIs/ARBs.

show abstract

Section: Discussionmentioning

confidence: 99%

Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry

Suki,

Zuhdi,

Yahya

et al. 2024

Saudi Journal of Medicine &Amp; Medical Sciences

View full text Add to dashboard Cite

show abstract

Prevalence and association of medication nonadherence with major adverse cardiovascular events in patients with myocardial infarction

Hou¹,

Yue²,

Zhao

et al. 2019

Medicine

View full text Add to dashboard Cite

Current study was to evaluate the prevalence of guideline recommended medications adherence in myocardial infarction (MI) patients postpercutaneous coronary intervention (PCI) and the association of medication nonadherence and major adverse cardiovascular events (MACEs). MI patients who underwent PCI in the last 12 months were enrolled. Demographic and clinical characteristics were collected and guideline recommended medications were evaluated. Patients were divided into with and without MACEs groups. Compared to patients without MACEs, those with MACEs were older (54.8 ± 16.4 vs 51.1 ± 15.2 years), more likely to be smoker (40.2% vs 31.9%), have higher body mass index (BMI; 25.0 ± 6.1 vs 23.8 ± 5.7 kg/m2), diabetes (47.5% vs 37.8%), ischemic stroke (34.4% vs 25.6%), and estimated lower glomerular filtration rate (85.4 ± 9.6 vs 92.6 ± 10.7 mL/minute/1.73 m2). Patients with MACEs were also more likely to present with ST-elevation MI (STEMI; 54.1% vs 48.4%) and to undergo urgent PCI (62.3% vs 56.3%). Furthermore, patients with MACEs were less likely to adhere to dual antiplatelet therapy (77.9% vs 85.9%), renin−angiotensin system inhibitor (62.3% vs 69.7%), and beta-blocker (69.7% vs 72.8%) treatment. In unadjusted model, medication nonadherence was associated with 2-fold higher odds of MACEs. After adjustment for demographics, risk factors, comorbidities, and peri-PCI characteristics, medications nonadherence remained independently associated with MACEs, with odds ratio of 1.40 (95% confidence interval: 1.29–1.87). Medications adherence rate among MI patients post-PCI is suboptimal in China, which is independently associated with MACEs.

show abstract

ABCB1 polymorphism in clopidogrel-treated Montenegrin patients

Mugosa

Todorović

Cukic³

et al. 2021

Open Life Sciences

View full text Add to dashboard Cite

Clopidogrel is an antiplatelet drug that displays significant interindividual variability in treatment response. Its bioavailability depends on the function of P-glycoprotein (P-gp), which is coded by a highly polymorphic ABCB1 gene. Thus, the aim of this study was to investigate the effect of ABCB1 genetic polymorphism on clopidogrel efficacy and safety and to determine the frequency distribution of its most common single nucleotide polymorphisms (SNPs) in 106 Montenegrin cardiology patients. Clopidogrel efficacy and safety were followed up during 1 year after hospitalization, with the lack of efficacy and adverse drug reactions observed in 11 (10.4%) and 8 patients (7.5%), respectively. Genotyping for ABCB1 SNPs rs1128503 (1236C > T), rs2032582 (2677G > A/T), and rs1045642 (3435C > T) was performed by the real-time PCR method, and the variant alleles were detected with the frequencies of 42.9, 44.8, and 52.8%, respectively. No significant association was observed between any of the examined genotypes and clopidogrel efficacy (p = 0.253) or safety (p = 0.424). Due to small sample size, co-treatment with other drugs, and other genetic factors not taken into account, we believe the absence of correlation between ABCB1 genotypes and indicators of clopidogrel efficacy and safety in this study should be apprehended conditionally, and that larger and better-controlled studies are warranted.

show abstract

Optimizing prevention and guideline-concordant care in Montenegro

Cited by 3 publications

References 31 publications

Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry

Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry

Prevalence and association of medication nonadherence with major adverse cardiovascular events in patients with myocardial infarction

ABCB1 polymorphism in clopidogrel-treated Montenegrin patients

Contact Info

Product

Resources

About