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What is known and objective: The use of medications for secondary prevention is the cornerstone in the treatment of coronary artery disease (CAD). However, adherence to these medications is still suboptimal worldwide. This retrospective observational study aimed to assess the adherence to post‐percutaneous coronary intervention (PCI) medications, along with predictors of non‐adherence. Methods: We conducted a retrospective observational cohort study to assess the adherence to post‐PCI medications by determining the rate of prescription refills for 12 months after discharge among STEMI patients, as well as predictors of non‐adherence. Adherence was assessed by medication availability 80% of the time monitored by the prescription refills rate for 1 year post‐discharge. Results and discussion: A total of 1334 patients who presented with STEMI and underwent primary PCI were included in our retrospective analysis. The majority of patients included were male (96%) with a mean age of 51 ± 10.2 years. The overall adherence rate for all medications was only 28.4%, with an individual adherence rate of 50.5% for aspirin, 49.9% for P2Y12 inhibitors, 48.1% for statins, 39.6% for beta‐blockers and 42.9% for angiotensin‐converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB). Factors that increased the likelihood of non‐adherence were prolonged hospital length of stay and getting the medications with charge (aOR = 1.94, 95% CI 1.1–3.3; p‐value = 0.017, aOR = 1.87, 95% CI 1.1–3.3; p‐value = 0.029, respectively), while having a regular follow‐up after discharge and attending the first clinic appointment were significantly associated with decreased likelihood of non‐adherence (aOR = 0.01, 95% CI 0.004–0.04; p‐value < 0.001, aOR = 0.06, 95% CI 0.03–0.1; p‐value < 0.001, respectively). What is new and conclusion: The adherence rate to post‐PCI medications among patients with STEMI was relatively low; however, attending the first outpatient clinic appointment and having a regular follow‐up reduced the likelihood of non‐adherence. [ABSTRACT FROM AUTHOR]

Aims: To compare the effectiveness and safety of 2 high‐intensity atorvastatin doses (40 mg vs 80 mg) among acute coronary syndrome (ACS) patients. Methods: This retrospective observational cohort study using real‐world data included patients admitted with ACS to the Heart Hospital in Qatar between 1 January 2017 and 31 December 2018. The primary endpoint was a composite of cardiovascular disease‐associated death, nonfatal ACS and nonfatal stroke. Cox proportional hazard regression analysis was used to determine the association between the 2 high‐intensity atorvastatin dosing regimens and the primary outcome at 1 month and 12 months postdischarge. Results: Of the 626 patients included in the analyses, 475 (75.9%) received atorvastatin 40 mg, while 151 (24.1%) received atorvastatin 80 mg following ACS. Most of the patients were Asian (73%), male (97%) with a mean age of 50 years and presented with ST‐elevation myocardial infarction (60%). The incidence of the primary effectiveness outcome did not differ between the atorvastatin 40‐and 80‐mg groups at 1 month (0.8 vs 1.3%; adjusted hazard ratio = 0.59, 95% confidence interval 0.04–8.13, P =.690) and at 12 months (3.2 vs 4%; adjusted hazard ratio = 0.57, 95% confidence interval 0.18–1.80, P =.340). Similarly, the use of the 2 doses of atorvastatin resulted in comparable safety outcomes, including liver toxicity, myopathy and rhabdomyolysis with an event rate of <1% in both groups. Conclusion: The use of atorvastatin 40 mg in comparison to atorvastatin 80 mg in patients with ACS resulted in similar cardiovascular effectiveness and safety outcomes. [ABSTRACT FROM AUTHOR]

Background: Secondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context. Methods: This retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge. Results: A total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P =.002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P =.004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P =.038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P =.018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers. Conclusion: Medication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI. [ABSTRACT FROM AUTHOR]