Pharmacotherapy in patients with stable coronary artery disease treated on an outpatient basis in Poland. Results of the multicentre RECENT study.

BACKGROUND

Comprehension of therapeutic methods in patients with stable coronary artery disease (CAD) is mandatory for the introduction of successful prevention.

AIM

To gather information regarding individuals with stable coronary artery disease treated by specialists and general practitioners on an outpatient basis.

METHODS

A representative group of 215 general practitioners and 67 specialists participated in this study. The analysis contains data concerning pharmacotherapy in a group of 2,593 patients with stable CAD (mean age - 65.0+/-9.8 years, women - 44.6%).

RESULTS

The patients received the following treatment: acetylsalicylic acid - 75.3%, other antiplatelet drugs - 6.6% (antiplatelet drugs altogether - 81.9%), beta-blockers - 81.1%, ACE-I - 78.8%, statins - 71.9%, fibrates - 4.7%, long-acting nitrates - 53.0%, short--acting nitrates - 33.1%, molsidomine - 18.2%, calcium channel blockers - 23.8%, metabolic drugs (trimetazidine) - 13.4%, diuretics - 43.5%, and angiotensin receptor antagonists - 1.7% of patients. Drugs classified as non-cardiological were received by 36.2% of patients. The optimal pharmacotherapy including four medications, one from each therapeutic class used in order to improve the prognosis of the patient (an antiplatelet drug, a beta-blocker, an ACE-I, statin), was received by a total of 45.8% of the participants, three medications by 31.7%, two medications by 15.8%, and one medication by 5.5%; 1.2% of the participants did not receive any medication from the four groups of drugs improving prognosis. What is worth noting, however, is the use of relatively small doses of ACE-I and beta-blockers. 69.9% of patients also received at least one symptomatic drug (a long-acting nitrate, a calcium channel blocker, a metabolic drug, molsidomine), including 39.7% - 1 drug, 22.7% - 2 drugs, 6.7% - 3 drugs, and 0.8% - 4 drugs from the classes mentioned above.

CONCLUSIONS

The results of the RECENT study indicate that great progress has been made in the pharmacotherapy of CAD in Poland within the last few years. Currently, the majority of patients receive drugs that improve prognosis. The awareness of the benefits of the use of combined treatment with all the drug groups and their appropriate doses should be higher. The significant percentage of patients with persisting symptoms of angina pectoris indicates the necessity to improve the efficacy of intervention also in this respect.