Use of secondary preventive drugs in patients with acute coronary syndromes treated medically or with coronary angioplasty: results from the nationwide French PREVENIR survey.

BACKGROUND

There is evidence that several classes of drugs are beneficial for secondary prevention in patients with coronary artery disease.

OBJECTIVE

To compare the use of secondary preventive drugs in patients with acute coronary syndromes given conservative treatment or percutaneous coronary interventions.

DESIGN

The PREVENIR survey was designed to assess the management of patients with acute coronary syndromes admitted to hospital in France in January 1998. Drugs prescribed at hospital discharge were recorded retrospectively from the hospital records, and treatment at six months was assessed prospectively.

SETTING

University hospitals, general hospitals, and private clinics throughout the country.

RESULTS

Of 1394 patients participating in the survey, 668 underwent coronary angioplasty during the initial hospital stay and 706 had medical treatment only. At hospital discharge, aspirin, beta blockers, and statins were prescribed significantly more often in patients undergoing angioplasty. Using multivariate logistic regression, coronary angioplasty was an independent predictor of treatment with aspirin (odds ratio 3.55), statins (1.92), and beta blockers (1.41). Compared with treatment at discharge, only statin use differed at six months, with a significant increase both in patients treated medically and in those who had undergone angioplasty. Increased use of statins, aspirin, and beta blockers was significantly correlated with coronary angioplasty during the initial hospital stay.

CONCLUSIONS

In this national French survey, patients treated with percutaneous coronary interventions were more likely to receive secondary preventive drugs than patients receiving medical treatment alone.