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Evaluation of clinical practice in prescribing dual antiplatelet therapy following acute coronary syndrome in a tertiary care hospital
Abstract
AIM: To evaluate the clinical practice in prescribing dual antiplatelet therapy following acute coronary syndrome.
OBJECTIVE:
- To conduct an observational study to evaluate adherence to guidelines on prescription of DAPT following ACS.
- To assess episodes of major bleeding experienced by patients taking DAPT beyond 12 months.
MATERIALS AND METHODS: In this study 75 patients were recruited who were diagnosed as ACS and revived their prescription to evaluate adherence to guidelines on prescription of DAPT (two antiplatelet drugs, and duration) with the current AMA/AHA and ECC guidelines. Clinician’s attitude towards prescribing DAPT beyond one year is assessed. Another aspect of study is to look into any major bleeding events experienced by the patient.
RESULTS: A total of 75 patients were included in the study and their details were recorded in DCF. Out of 75 patients 76% of patients took DAPT for >1year,and the other 24% of patients took it for one year. Totally 31% of patients were in line with guidelines where as 69% patients prescription was out if guidelines. In 75 patients 20 patients had bleeding events in which 2 patients had taken DAPT for 1 year and rest for long duration.
CONCLUSION: shorter duration of DAPT (1 year) is associated with lesser ischemic events and reoccurrence of cardiovascular events in patients following ACS along with low adverse bleeding episodes. Hence, following guidelines we can achieve maximum clinical effect with minimum adverse effects. Further studies are necessary to prove the improved benefits of DAPT in shorter duration.
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