Investigation On Current Situation Of Secondary Prevention Medication For Patients With Acute Coronary Syndrome (ACS)

Background Acute coronary syndrome (ACS) is a common form of fatal coronary artery disease, including ST elevated myocardial infarction (STEMI), non-ST elevated myocardial infarction (NSTEMI), unstable angina pectoris (UAP) and cardiac sudden death. In the past decades, the prognosis of ACS was not obviously ameliorated even with emerging therapeutics. The purpose of secondary prevention, mainly including standardization of medical care and improved life-style, is to diminish the occurrence of adverse cardiac event. The standardization of medical care includes anti-platelet drugs, lipid-regulating agents, β-blocker, and angiotension-converting enzyme inhibitor/ angiotensin Ⅱ receptor antagonists.Objective To investigate the consumption of secondary prevention drugs in acute coronary syndrome patients after 12-month discharge from hospital; to compare biochemical indicators, blood pressure and major adverse cardiovascular events between standardized secondary prevention and regular secondary prevention of ACS patients; to provide the scientific evidences of standardized secondary prevention medication for ACS patients with clinical experiments.Methods A total enrollment of 251 patients (188 male,63 female) from December 2012 to July 2013 after standard diagnosis of ACS in the Cardiology Department of Nanyang Central Hospital, were assigned to 2 groups:standardized secondary prevention group (Group A,104 patients) and regular secondary prevention group (Group B,159 patients) according to medication adherence. The age of the patients was 60.23±12.60. Among them, 92 patients were with acute myocardial infarction, and 159 with unstable angina. The questionnaire is employed as the research tool. Without being interfered therapies, Group A took standardized medication in accordance with the guidelines, while Group B failed to medicine according to the guidelines. Both groups were given guiding medication and lifestyle intervention with a follow-up every 3 months, and a total of 4 times. Collect the clinical data of two groups, Then Process Statistical Analysis, and P<0.05 was statistically significant.Results After 12-month follow-up, Group A has a better drug adherence (aspirin 100%, statins 100%, β-blocker 98.9%, ACEI/ARB 98.9%) than Group B (aspirin 99.2%, statins 78.6%, β-blocker 60.2%, ACEI/ARB 58.0%). There are differences (P<0.05)between cholesterol (3.66±0.77 vs.4.26±0.71, P=0.045), LDL (2.10±0.56 vs. 2.63±0.50, P=0.039) but not TG (1.80±0.94vs2.01±0.97), HDL(1.21±0.32vs 1.12±0.29) (P>0.05), and fasting plasmaglucose(5.64±2.78vs5.71±2.62).End-systolic pressure (131.51±9.64vs135.12±15.21) and end-diastolic pressure (78.25±8.69vs79.24±8.80) showed no statistical difference (P>0.05). Group A has lower than group B (0% vs 7.3%) and there is statistical difference (P<0.05).Conclusion Standardized secondary prevention medication can obviously diminish the occurrence of adverse cardiac events in ACS patients.