Researchers conducted a study of the GWTG database to determine to what degree hospitalized patients with coronary artery disease were receiving the appropriate medications and advice at discharge. They divided that data of 119,106 hospitalized patients into three groups: those who received CABG (14,118); those who received PCI (58,702), which included balloon angioplasty and stenting to open blocked arteries; and those who didn't receive either intervention (46,286).
Surprisingly, researchers found that CABG patients were less likely than PCI patients to receive all of GWTG's recommended measures, even when taking into account the exclusion of certain patients for which the measures wouldn't be medically appropriate.
"CABG patients are in the hospital for several days after the operation, during which time we have multiple opportunities to stress to them the Get With The Guidelines prevention measures," said Hiratzka, chair of the American Heart Association's Council of Cardiovascular Surgery and Anesthesia and medical director of cardiac surgery, TriHealth, Inc., Cincinnati, Ohio. "Some PCI patients tend to be in the hospital for less than 24 hours; even then, healthcare providers have opportunities before and after the procedure to meet with patients and their families to review these topics."
Get With The Guidelines performance measures include: prescribing angiotensin-converting enzyme (ACE) inhibitors, when appropriate; recommending that patients take aspirin; prescribing appropriate beta blockers for blood pressure and heart rate control; giving smoking cessation advice if patients are smokers; and prescribing statins and other kinds of cholesterol lowering medications.
The study found these measures were provided as follows for patients without exclusions or contraindications for each group:
-- ACE (angiotensin-converting enzyme) inhibitors
* PCI patients -
|SOURCE American Heart Association|
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