Assessment of predisposing factors and prescribing pattern in coronary artery disease patients at a tertiary care hospital of Southern Rajasthan
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20250490Keywords:
Coronary artery disease, Risk factors, Prescribing pattern, Antiplatelets, AnticoagulantsAbstract
Background: Coronary artery disease (CAD) is the leading cause of mortality globally. The risk factors for the development of cardiovascular disease include lifestyle changes, diabetes mellitus, hypertension, smoking, hyperlipidemia, obesity and psychosocial stress. Drug regime plays an important role in declining the untimely deaths and enhances the quality of life. Few studies have been done on the prescribing patterns of CAD; hence the main objective of the study was to scrutinize various risk factors and therapy patterns for CAD patients.
Methods: A non-interventional prospective study was conducted among 120 patients, to assess the risk factors and prescribing pattern in CAD patients. Information regarding patients was recorded in data collection form. Data was statistically analyzed using IBM statistical package for the social sciences (SPSS) software.
Results: Majority of the patients were male (77.5%). Most of the patients (59.20%) were in age range of 50-69 years. Most common co-morbidities found were hypertension and diabetes. Body mass index (BMI), tobacco chewing, smoking were major risk factors. Majorly prescribed drugs were antiplatelets, anticoagulants, statins, antibiotics, nitrates, antihypertensive, PPI’s and analgesics. Average number of drugs encountered per prescription was 8.70. While number of encounters with a drug indicated in CAD was 5.66. Number of drugs prescribed with an injection and generic name were 4 and 1 respectively. As per DDD calculation, Heparin was consumed in highest amount.
Conclusions: Polypharmacy was practiced. Generic prescribing was low. Major risk factors included BMI, tobacco chewing, smoking, diabetes and hypertension. Findings of this study can be used to develop a framework for ongoing prescription assessment in a healthcare setting.
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References
Khera AV, Kathiresan S. Genetics of coronary artery disease: discovery, biology and clinical translation. Nat Rev Genet. 2017;18(6):331-44. DOI: https://doi.org/10.1038/nrg.2016.160
Roy A, Patel NK. Prescribing patterns of cardiovascular drugs in cardiology outpatient department in a tertiary care hospital in Western Odisha. Int J Basic Clin Pharmacol. 2021;10(1):23-8. DOI: https://doi.org/10.18203/2319-2003.ijbcp20205533
ESC Guidelines for the management of chronic coronary syndromes. Available at: https://www.escar dio.org/Guidelines/Clinical-Practice-Guidelines/ Chronic-Coronary-Syndromes. Accessed on 29 December 2024.
Dipro JT, Talbert RL, Yee GC, Matzke GR, Wells BG. Pharmacotherapy: a pathophysiologic approach. 7th edition. New York: McGraw-Hill. 2008. DOI: https://doi.org/10.1345/aph.1L477
Penman I, Ralston SH, Strachan M, Hobson R. Davidson’s Principles and Practice of Medicine. 24th Edition. Elsevier. 2022.
Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. 2021;11(2):169-77. DOI: https://doi.org/10.2991/jegh.k.201217.001
Gupta R. Recent trends in coronary heart disease epidemiology in India. Indian Heart J. 2008;60(2 B):B4-18.
Tripathi KD. Essentials of Medical Pharmacology. JP Medical Ltd. 2013. DOI: https://doi.org/10.5005/jp/books/12256
Castini D, Persampieri S, Cazzaniga S, Ferrante G, Centola M, Lucreziotti S, et al. Real-world clopidogrel utilization in acute coronary syndromes: patients selection and outcomes in a single-center experience. Ther Adv Cardiovasc Dis. 2017;11(12):323-31. DOI: https://doi.org/10.1177/1753944717738911
Lee CW. Dual antiplatelet therapy for coronary artery disease. Circ J. 2015;79(2):255-62. DOI: https://doi.org/10.1253/circj.CJ-14-1348
Dzeshka MS, Brown RA, Lip GYH. Patients with atrial fibrillation undergoing percutaneous coronary intervention. Current concepts and concerns: part I. Pol Arch Med Wewn. 2015;125(1–2):73-81. DOI: https://doi.org/10.20452/pamw.2650
Husted SE, Ziegler BK, Kher A. Long-term anticoagulant therapy in patients with coronary artery disease. Eur Heart J. 2006;27(8):913-9. DOI: https://doi.org/10.1093/eurheartj/ehi714
13. Lu CH, Fang CW, Chen HM, Fang YP, Fang CT, Huang YB, et al. Prescribing patterns of coronary artery aneurysm in Taiwan. BMC Cardiovasc Disord. 2019;19(1):188. DOI: https://doi.org/10.1186/s12872-019-1172-6
Truong TTA, Phan NK, Vo QV, Diep HG, Vuong HTK, Le TV, et al. Drug-related problems in prescribing for coronary artery diseases in Vietnam: cross-sectional study. Trop Med Int Health. 2019;24(11):1335-40. DOI: https://doi.org/10.1111/tmi.13310
Mukadam FM, Gawali UP, Chavarkar P, Ali DP, Naghotkar S. Prescription Patterns of Drugs Used in Patients with Coronary Artery Disease at Tertiary Care Hospital. J Pharm Care. 2022;97-102. DOI: https://doi.org/10.18502/jpc.v10i3.10789
Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019;234(10):16812-23. DOI: https://doi.org/10.1002/jcp.28350
Shahjehan RD, Sharma S, Bhutta BS. Coronary Artery Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025.
Cassar A, Holmes DR, Rihal CS, Gersh BJ. Chronic coronary artery disease: diagnosis and management. Mayo Clin Proc. 2009;84(12):1130-46. DOI: https://doi.org/10.4065/mcp.2009.0391
Kandaswamy E, Zuo L. Recent Advances in Treatment of Coronary Artery Disease: Role of Science and Technology. Int J Mol Sci. 2018;19(2):424. DOI: https://doi.org/10.3390/ijms19020424
Agrawal H, Aggarwal K, Littrell R, Velagapudi P, Turagam MK, Mittal M, et al. Pharmacological and non pharmacological strategies in the management of coronary artery disease and chronic kidney disease. Curr Cardiol Rev. 2015;11(3):261-9. DOI: https://doi.org/10.2174/1573403X1103150514155757
Solanki ND, Patel N, Desai S, Patel V. Coronary artery disease prescribing pattern and risk factor assessment in the patients undergoing angioplasty. Int J Basic Clin Pharmacol. 2021;10(5):517-22. DOI: https://doi.org/10.18203/2319-2003.ijbcp20211646
Dawalji S, Thota S, Venisetty P, Venisetty RK, Raj K, Venisetty. Prescribing Pattern in Coronary Artery Disease: A Prospective Study. Int J Pharm Res Rev. 2014;3:24-33.
Belhekar MN, Patel TC, Singh MK, Pandit PR, Bhave KA, Redkar NN. Evaluation of prescribing pattern of drugs use in patients of coronary artery disease at a tertiary care hospital. Int J Basic Clin Pharmacol. 2018;7(9):1792-6. DOI: https://doi.org/10.18203/2319-2003.ijbcp20183491
Thangavel VD. Consequences of Human Consumption of Refined Edible Oil, Which is Debatable and Bad for Health. Government Obligation to Offer Appropriate Education Services: Research Analysis. Neurol Neurotherapy Open Access J. 2023;8. DOI: https://doi.org/10.23880/nnoaj-16000185
World Health Organization. Prevention of cardiovascular disease: guidelines for assessment and management of total cardiovascular risk. Available at: https://www.who.int/publications/i/item/9789241547178. Accessed on 28 November 2024.