Adherence to ESC guideline-directed medical therapy at discharge after ACS was 74.5% for all 5 medication classes prescribed, increasing to 89.7% when including documented contraindications or intolerance.
Observational (n=428)
Yes
Adherence to guideline-directed medical therapy at discharge after ACS in Georgia is high (89.7% when accounting for contraindications), though achieving optimal target doses remains a significant gap.
Effect estimate: 89.7% complete adherence when including documented contraindications/intolerance
Abstract Background The aim of the study was to investigate the adherence to ESC guidelines in patients discharged after ACS in Georgia. Patients and methods A prospective observational study was performed in 2 cardiac hospitals in Tbilisi from March 2021 till June 2022. A total of 428 consecutive patients with confirmed diagnosis of Acute Coronary Syndrome at discharge were evaluated. The primary outcome was defined as adherence to Guideline Directed Medical Therapy (GDMT) at discharge post-Acute Coronary Syndrome. Results Complete guideline adherence for the combination of 5 medication classes was 74.5%, and additionally in 15.2% contraindications or intolerance were well documented, so the complete guideline adherence was very high − 89.7%. The guideline adherence for individual drug class differed from 98.9% for ACE inhibitors/ARB and acetylsalicylic acid to 92.9% for P2Y12 receptor inhibitor. Conclusion Adherence to GDMT according to the data received from 2 hospitals is promising, but efforts to further improve guideline adherence must be targeted toward patient groups who receive the worse treatment at discharge, e.g. NSTEMI patients and only medical treatment sub-group.
David Gogoberidze (Mon,) conducted a observational in Acute Coronary Syndrome (STEMI, NSTEMI, UA) (n=428). Guideline Directed Medical Therapy (GDMT) per ESC guidelines was evaluated on Adherence to prescribing all 5 classes of medications per ESC guideline-directed medical therapy at discharge (aspirin, P2Y12 inhibitor, statin, beta-blocker, ACE inhibitor/ARB) (89.7% complete adherence when including documented contraindications/intolerance). Adherence to ESC guideline-directed medical therapy at discharge after ACS was 74.5% for all 5 medication classes prescribed, increasing to 89.7% when including documented contraindications or intolerance.