Background: Optimal medical therapy and the management of cardiac risk factors are crucial for the secondary prevention of acute coronary syndrome (ACS). However, there have been reports on the underutilization of secondary-prevention medications for ACS. This study aimed to investigate adherence of in-hospital prescriptions to clinical practice guidelines for the secondary prevention of ACS using real-world data.
Materials and methods: We collected information on ACS patients from national insurance claims data. The in-hospital prescriptions of secondary-prevention medications for post-ACS patients were analyzed. Prescription patterns were analyzed in relation to demographic, clinical, and institutional features. The utilization of five recommended medications and the factors influencing their use were investigated using logistic regression analysis.
Results: In total, 1,983 ACS patients were included in this analysis. The prescription rates of secondary-prevention medications were 94.4% for aspirin, 96.1% for P2Y12 inhibitors, 67.4% for β-blockers, 63.5% for ACE inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), and 86.5% for statins. Less than half of the patients were prescribed all five recommended medications. The prescription rate of secondary-prevention medications was lower in patients with unstable angina than in patients with myocardial infarction, particularly for β-blockers and ACEIs/ARBs. The best predictive variable for determining the use of all five recommended medications was the type of ACS according to the results of the logistic regression analysis.
Conclusions: In Korea, there is room for improvement in the prescription rates of secondary-prevention medications in post-ACS patients, particularly for β-blockers and ACEIs/ARBs. .