Background The administration of an intensive dose of statins after acute myocardial infarction (AMI) has proved to be superior to conventional doses in reducing morbidity and mortality (IA evidence) but application in clinical practice is variable.
Purpose To find out whether intensive statins doses are being used after AMI and the involvement of an emergency clinical pharmacist in this quality measure.
Material and methods The study was conducted from February to April 2014 in an emergency room with a clinical pharmacist of a tertiary hospital. Patients with AMI were recorded and their discharge reports of hospitalisation and blood tests were reviewed. An Excel sheet with the following items was prepared: Patient sex, age, basal low density lipoproteins (LDL), intensive doses of statins after AMI (YES/NO), pharmaceutical intervention to modify the dose of statins to intensive dose (YES/NO), LDL levels at discharge, type and dose of statin scheduled in the discharge report. The target LDL levels after AMI were lower than 70 mg/dl according to clinical practice guidelines (GPC) of the European society of Cardiology (ESC) 2013.
Results 32 AMIs were recorded. A previous blood test including LDL levels was available in 22 patients, in 95.5% these exceeded 70 mg/dl. 84.4% of the patients received intensive doses of statins in the emergency room, 40.7% prescribed by the physician and 59.3% prescribed after a recommendation by the clinical pharmacist. At hospital discharge all patients except one were prescribed an statin. No patients were discharged with intensive doses.
The use of intensive statins doses in the emergency room is high but It Is necessary to unify criteria at hospital discharge.
The pharmaceutical recommendation to use intensive doses of statins after AMI implies an increase in compliance with evidence-based recommendations of the GPC.
References and/or Acknowledgements
Rev Esp Cardiol 2013;66(1):53.e1–46
Journal of Geriatric Cardiology 2013;10:355–60
References and/or AcknowledgementsNo conflict of interest.
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