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THE CLOSE RELATIONSHIP BETWEEN DRUG INTOLERANCE AND MAJOR CARDIAC AND CEREBROVASCULAR EVENTS AFTER AN ACUTE CORONARY SYNDROME OR CORONARY REVASCULARIZATION
44 JACC March 21, 2017 Volume 69, Issue 11
Acute and Stable Ischemic Heart Disease THE CLOSE RELATIONSHIP BETWEEN DRUG INTOLERANCE AND MAJOR CARDIAC AND CEREBROVASCULAR EVENTS AFTER AN ACUTE CORONARY SYNDROME OR CORONARY REVASCULARIZATION Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Updates in Stable Ischemic Heart Disease Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy Presentation Number: 1125-304 Authors: Sara Doimo, Stefano Albani, Alessandro Altinier, Patrizia Maras, Giulia Barbati, Gianfranco Sinagra, Cardiovascular Department, Univeristy Hospital “Ospedali Riuniti”, Trieste, Italy
Background: the occurrence of drug intolerance (DI) to recommended therapy after an acute coronary syndrome (ACS) or coronary revascularization (CR) is the most important reason of quitting treatment. Nevertheless the association between DI and major cardiac and cerebrovascular events (MACCE) is poorly reported in literature. We analyzed the relationship between DI and MACCE in one year followup.
Methods: from 2014 to 2015, 899 consecutive patients after ACS or CR were referred to cardiac ambulatory for a clinical follow-up and were included in a registry. During a mean observational period of 5 ± 4 months, DI were analyzed and the treatment was appropriately modified, moreover, we registered all MACCE (defined as hospitalization for cardiovascular or cerebrovascular causes) occurred within one year after discharge.
Results: 293 patients (33%) developed DI, 73% of them were female. 13% of patients were intolerant to ACE inhibitors, 13% statin, 8% beta-blockers, 6% calcium channel blockers, 4% nitrates and 3% aspirin and 1% ranolazine. 10% of patients had DI to two drugs and 1% to three drugs. MACCE involved 24% of patients with DI and 13% without DI (p= 0.002). MACCE were reported in 16% of patients with two DI (p= 0.010). DI to ACE inhibitors and nitrates were related with more incidence of MACCE (21%, p= 0.018 and 9% p= 0.026 respectively). Conclusions: DI is significantly associated with MACCE. Patients intolerant to ACE inhibitors, nitrates or two drugs have a high risk of MACCE.
Acute and Stable Ischemic Heart Disease THE CLOSE RELATIONSHIP BETWEEN DRUG INTOLERANCE AND MAJOR CARDIAC AND CEREBROVASCULAR EVENTS AFTER AN ACUTE CORONARY SYNDROME OR CORONARY REVASCULARIZATION Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Updates in Stable Ischemic Heart Disease Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy Presentation Number: 1125-304 Authors: Sara Doimo, Stefano Albani, Alessandro Altinier, Patrizia Maras, Giulia Barbati, Gianfranco Sinagra, Cardiovascular Department, Univeristy Hospital “Ospedali Riuniti”, Trieste, Italy
Background: the occurrence of drug intolerance (DI) to recommended therapy after an acute coronary syndrome (ACS) or coronary revascularization (CR) is the most important reason of quitting treatment. Nevertheless the association between DI and major cardiac and cerebrovascular events (MACCE) is poorly reported in literature. We analyzed the relationship between DI and MACCE in one year followup.
Methods: from 2014 to 2015, 899 consecutive patients after ACS or CR were referred to cardiac ambulatory for a clinical follow-up and were included in a registry. During a mean observational period of 5 ± 4 months, DI were analyzed and the treatment was appropriately modified, moreover, we registered all MACCE (defined as hospitalization for cardiovascular or cerebrovascular causes) occurred within one year after discharge.
Results: 293 patients (33%) developed DI, 73% of them were female. 13% of patients were intolerant to ACE inhibitors, 13% statin, 8% beta-blockers, 6% calcium channel blockers, 4% nitrates and 3% aspirin and 1% ranolazine. 10% of patients had DI to two drugs and 1% to three drugs. MACCE involved 24% of patients with DI and 13% without DI (p= 0.002). MACCE were reported in 16% of patients with two DI (p= 0.010). DI to ACE inhibitors and nitrates were related with more incidence of MACCE (21%, p= 0.018 and 9% p= 0.026 respectively). Conclusions: DI is significantly associated with MACCE. Patients intolerant to ACE inhibitors, nitrates or two drugs have a high risk of MACCE.