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Article
TCT-221: Predictors of optimal medical therapy on discharge after percutaneous coronary intervention for acute coronary syndrome: An analysis of the prometheus registry
Journal of the American College of Cardiology
  • Serdar Farhan
  • Usman Baber
  • Jaya Chandrasekhar
  • Samantha Sartori
  • Melissa Aquino
  • Gennaro Giustino
  • Annapoorna Kini
  • William Weintraub
  • Sunil Rao
  • Samir Kapadia
  • Sandra Weiss
  • Craig Strauss
  • Catalin Toma
  • J. Brent Muhlestein
  • Anthony DeFranco, Auroa Health Care
  • 1 Mark Effron
  • Stuart Keller
  • Brian Baker
  • Stuart Pocock
  • Timothy Henry
  • Roxana Mehran
Aurora Affiliations

Aurora St Luke’s Medical Center

Publication Date
11-1-2016
Abstract
BACKGROUND: Current guidelines recommend the use of betablockers, statins and renin-angiotensin-system-inhibitors (RAS) in addition to dual antiplatelet therapy (DAPT) for secondary prevention following acute MI. However the prevalence and correlates of optimal medical therapy (OMT) in clinical practice remains unknown. METHODS: PROMETHEUS was a multicenter observational US study in patients undergoing PCI. We included 2389 STEMI and 4450 NSTEMI patients. OMT was defined as discharge on a beta-blocker, statin and RAS, in addition to DAPT. Independent correlates of discharge on OMT were identified using multivariable logistic regression. Adjusted Cox-regression analyses for major adverse cardiac events (MACE) at 1- year were estimated. RESULTS: Patients discharged on OMT (n¼4687, 69%) were younger with less frequent history of PCI, peripheral and cerebral vascular disease and multivessel disease compared with those not receiving OMT (n¼2152, 31%). Adjusted predictors of OMT were ST-elevation MI presentation, hypertension, diabetes mellitus, left ventricular ejection fraction CONCLUSION: In contemporary US practice, OMT is prescribed in two thirds of MI patients undergoing PCI. Chronic kidney disease and anemia are independent predictors of reduced OMT prescription.
Document Type
Abstract
DOI
10.1016/j.jacc.2016.09.272
Citation Information

Farhan S, Baber U, Chandrasekhar J, et al. TCT-221 Predictors of optimal medical therapy on discharge after percutaneous coronary intervention for acute coronary syndrome: An analysis of the PROMETHEUS registry. Journal of the American College of Cardiology. 2016;68(18).