Guideline-based medications for older adults discharged after percutaneous coronary intervention in a suburban city of Japan: A cohort study using claims data

Koki Shimada, Shota Hamada, Mitsuaki Sawano, Hiroyuki Yamamoto, Satoru Yoshie, Katsuya Iijima, Hiroaki Miyata

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Secondary prevention with medications is essential for the better prognosis of patients who have experienced cardiovascular events. We aimed to evaluate the use of guideline-based medications for secondary prevention in older adults in the community settings after discharge following percutaneous coronary intervention (PCI). A retrospective cohort study was conducted using anonymized claims data of older beneficiaries in a suburban city of Japan between April 2012 and March 2015. The prescriptions of antiplatelets, statins, angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARB), and β-blockers were evaluated for 3 months before and after the month in which the participants underwent PCI. Multivariable logistic regression analysis was conducted to evaluate the associations of age (“pre-old” group [63-72 years] vs. “old” group [≥ 73 years]) and sex with the prescriptions, adjusting for whether a participant was followed-up by the PCI-performing hospital. Of 815 participants, 59.6% constituted the old group and 70.9% were men. The prescription rates for antiplatelets, statins, ACEi/ARB, and β-blockers after discharge were 94.6%, 65.0%, 59.3%, and 32.9%, respectively. The adjusted analysis indicated that statins were less likely to be prescribed for the old group (adjusted odds ratio [aOR], 0.70; 95% confidence interval [CI], 0.51-0.95; p = 0.023) and for men (aOR, 0.64; 95% CI, 0.45-0.89; p = 0.008). β-blockers were more likely to be prescribed for men (aOR, 1.66; 95% CI, 1.17-2.33; p = 0.004). Our results suggest the potential for improvements in secondary prevention by increasing the prescription rates of guideline-based medications in this population.

Original languageEnglish
Pages (from-to)143-152
Number of pages10
JournalTohoku Journal of Experimental Medicine
Volume252
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • Claims data
  • Coronary artery disease
  • Elderly
  • Percutaneous coronary intervention
  • Secondary prevention

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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