Daci Armond, Bozalija Adnan, Cavolli Raif, Alaj Rame, Beretta Giangiacomo, Krasniqi Shaip
Department of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo.
Cardiovascular Surgery Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo.
Open Access Maced J Med Sci. 2018 Mar 12;6(3):498-505. doi: 10.3889/oamjms.2018.132. eCollection 2018 Mar 15.
Coronary Artery Bypass Grafting (CABG) is realised in patients with critical or advanced disease of coronary arteries. There are different pharmacotherapeutic approaches which are used as management, treatment and preventive therapy in cardiovascular disease or related comorbidities. Performing a successful surgery, pharmacotherapy, and increase of bypass patency rate remains a serious challenge.
This study aims to analyse the patient characteristics undergoing CABG and evaluation of their drug utilisation rate and daily dosages in the perioperative period.
Data were collected from 102 patients in the period 2016-2017 and detailed therapeutic prescription and dosages, patient characteristics were analysed before the operation, after the operation and visit after operation in the Clinic of Cardiac surgery-University Clinical Center of Kosovo.
Our findings had shown that patients provided to have normal biochemical parameters in the clinic before the operation, and were related to cardiovascular diseases and comorbidities and risk factors with mainly elective intervention. The, however, higher utilisation of cardiovascular drugs such as beta blockers, diuretics, anticoagulants, statins and lower calcium blockers, ACEi, ARBs, hydrochlorothiazide, amiodarone were founded. ARBs, beta blockers, statins, nitrates and nadroparin utilisation decreased after operation and visit after the operation, whereas amiodarone only in the visit after the operation. Diuretics are increased after the operation which decreases in the visit after the operation. Regarding the daily dosage, only metoprolol was increased in the visit after operation (P < 0.001) and visit after operation (P < 0.05) whereas losartan and furosemide were increased (P < 0.01) and (P < 0.05) respectively.
The study showed that beta blockers, statins, aspirin, nitrates (before the operation), furosemide and spironolactone are the most utilised drugs. However, we found low utilisation rate for ACEi, ARBs, clopidogrel, nadroparin, warfarin, xanthines, amiodarone, calcium blockers. Daily dosages were different compared to before CABG only in metoprolol, losartan, and furosemide.
冠状动脉旁路移植术(CABG)适用于患有严重或晚期冠状动脉疾病的患者。在心血管疾病或相关合并症的管理、治疗和预防治疗中使用了不同的药物治疗方法。成功实施手术、药物治疗以及提高旁路通畅率仍然是一项严峻的挑战。
本研究旨在分析接受CABG患者的特征,并评估其围手术期的药物利用率和每日剂量。
收集了2016 - 2017年期间102例患者的数据,并在科索沃大学临床中心心脏外科诊所对详细的治疗处方和剂量、患者特征进行了术前、术后及术后随访分析。
我们的研究结果表明,患者术前在诊所的生化参数正常,主要为选择性干预,与心血管疾病、合并症及危险因素有关。然而,发现β受体阻滞剂、利尿剂、抗凝剂、他汀类药物等心血管药物的使用率较高,而钙通道阻滞剂、ACEI、ARB、氢氯噻嗪、胺碘酮的使用率较低。术后及术后随访时,ARB、β受体阻滞剂、他汀类药物、硝酸盐和那屈肝素的使用率下降,而胺碘酮仅在术后随访时下降。术后利尿剂增加,术后随访时减少。关于每日剂量,仅美托洛尔在术后随访(P < 0.001)和术后随访(P < 0.05)时增加,而氯沙坦和呋塞米分别增加(P < 0.01)和(P < 0.05)。
研究表明,β受体阻滞剂、他汀类药物、阿司匹林、硝酸盐(术前)、呋塞米和螺内酯是使用最多的药物。然而,我们发现ACEI、ARB、氯吡格雷、那屈肝素、华法林、黄嘌呤、胺碘酮、钙通道阻滞剂的使用率较低。与CABG术前相比,每日剂量仅在美托洛尔、氯沙坦和呋塞米方面有所不同。