Pharmacological adherence with clinical guidelines: Acute coronary syndrome

Background and aims: The present time evidences show that adherence of clinical guideline by cardiologists in Acute Coronary Syndrome is sub optimal. The aim of this studywas to investigate the extent adherence by cardiologists from clinical guidelines in acute coronary syndrome on admission in hospitals in Isfahan. Methods: This cross sectional study was conducted on medical records of Acute Coronary Syndrome patients (unstable angina and myocardial infarction). The pharmacological adherence calculated from prescription of 4 recommended medications from clinical guidelines utilizing aspirin clopidogrel, beta blockers, statins, ACEI (angiotensin- converting enzyme inhibitor) or ARB (angiotensin II receptor blockers). Pharmacological adherence were divided into two groups of good-adherence equals or above %75 (4.3, 4.4) and poor- adherence below %75 (1.4, 2.4). Results: This research performed on 200 medical records of Acute Coronary Syndrome (ACS) patients. On admission%99, %80, %58 and %96.5 of patients received antiplatelet, beta blockers, ACEI/ARB and statins, respectively. In general, the extent of pharmacological adherence to updated clinical guidelines on admission was%58.5 which was poor. Conclusion: Poor adherence to updated clinical guidelines by cardiologists due to secondary prevention of ACS is very worrisome. It is necessary to investigate the reasons of non-adherence regarding aging society and the prevalence of cardiac disease