Early occurrence of drug intolerance as risk factor during follow-up in patients with acute coronary syndrome or coronary revascularization

European Heart Journal. Cardiovascular Pharmacotherapy
Stefano AlbaniGianfranco Sinagra

Abstract

The occurrence of drug intolerance (DI) after an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) is an important reason for quitting treatment. Nevertheless, the association between DI and major cardiac and cerebrovascular events (MACCE) is poorly reported in the literature, therefore, we analysed potential relationship between DI and MACCE (a composite of ACS, PCI, heart failure, and stroke) during follow-up. From 1 January 2014 to 31 December 2015, 891 consecutive patients after ACS or coronary revascularization were referred to cardiac rehabilitation (CR) programme and included in a dedicated registry where DI was analysed and treatment appropriately tailored. Three hundred and nine patients (34.7%) developed DI, 26.9% of them were female. Angiotensin-converting enzyme (ACE) inhibitors and statins were the most frequent drugs which caused DI, followed by beta-blockers and calcium channel blockers, in 13.1%, 12.8%, 7.5%, and 5.5% of patients, respectively. During a median follow-up of 18 (interquartile range 11-24) months after CR, MACCE occurred in 14.1% of patients with DI and 8.1% without DI (P = 0.007). At multivariable model, DI to 1 drug [odds ratio (OR) 1.8, 95% confidence interval (CI) 1.01-3...Continue Reading

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Citations

Mar 17, 2020·European Heart Journal. Cardiovascular Pharmacotherapy
Oct 9, 2018·European Heart Journal. Cardiovascular Pharmacotherapy·Raul D Santos
Jan 8, 2020·European Heart Journal Supplements : Journal of the European Society of Cardiology·Jelena ČelutkienėOvidiu Chioncel

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