Role of optimal medication given to patients with hypertension and ischemic heart disease prior to an acute coronary syndrome

• Main Authors: Călin Pop, Roberta Florescu, Claudia Matei, Lavinia Pop, Viorel Manea, Coralia Cotoraci, Liana Mos, Antoniu Petris
• Format: Article
• Language: English
• Published: Touch Medical Media 2017-10-01
• Series: Heart International
• Online Access: http://www.heart-int.com/Attach/84719789-A605-4F3E-8D83-E97AFFA73B2F/F215CEC2-F07E-4C07-BCE0-9DA2B5CDD2FF

IntroductionAdministering optimal cardiovascular medication (OCM) to patients with hypertension (HBP) and ischemic heart disease (IHD) lowers cardiovascular morbidity and mortality.The main objective of this study was to compare in-hospital cardiac mortality among patients with HBP and/or IHD, treated or untreated with OCM, who developed a first episode of acute coronary syndrome (ACS).MethodsThe study was carried out retrospectively and included patients admitted with a first episode of ACS between 2013 and 2016. The patients were divided into three groups: those with HBP, IHD, and a history of HBP + IHD. Patients were then divided into two subgroups: subgroup A consisted of patients undergoing optimal anti-ischemic and/or antihypertensive therapy, while subgroup B consisted of patients without OCM.ResultsThis analysis comprised 1096 patients. Mean age was 64.3 ± 18 years. There were 581 patients in subgroup A – 53%, and 515 patients in subgroup B – 47%. Total cardiac mortality was 9.98%, different depending on the groups and subgroups studied: HBP group total – 7%, subgroup A – 5.1%, significantly lower compared to subgroup B – 9.4% (p = 0.05); IHD group total – 12.2%, subgroup A – 9.07%, significantly lower compared to subgroup B – 15.8% (p = 0.05); HBP + IHD group total – 14.35%, subgroup A – 9.9%, significantly lower compared to subgroup B – 18.8% (p = 0.05).ConclusionsThe lack of OCM in patients with HBP and/or IHD is correlated to a significant increase in in-hospital cardiac mortality among patients who develop a first-episode ACS.