OUTPATIENT REGISTRY OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (PROFILE-IM): DATA ON PREHOSPITAL THERAPY IN COMPARISON WITH THE LIS-3 REGISTRY

Aim. To study the quality of prehospital therapy in patients with a history of acute coronary syndrome/acute myocardial infarction (ACS/AMI), and included in 2 registers: LIS-3 and PROFILE-IM.

Material and methods. Data on therapy before the reference ACS in the hospital register LIS-3 (Lyubertsy town, 01.11.2013-31.07.2015) and in the AMI outpatient registry PROFILE-IM (Moscow city polyclinic N9) were compared. Anonymized data from the case histories (320 patients from the LIS-3 registry) and outpatient charts (160 patients from the PROFILE-IM register) were analyzed.

Results. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers before AMI in patients from PROFILE-MI were prescribed significantly more often than in the LIS-3 registry (49.4% vs 39.4%, respectively, p<0.05), as well as calcium channel blockers – 6.7% vs 5.3%, respectively (p<0.05). The frequency of prescription of statins, antiplatelet agents and anticoagulants before reference AMI in patients of both registers did not differ significantly. Assessment of adherence to treatment was performed in the PROFILE-IM registry. 56 (35.0%) patients did not take medication. Among cases with pharmacotherapy only 41 (39.4%) patients had regular taking, and 24 (23.1%) took medication in worsening health, 39 (37.5%) had only short medication courses. Similar data were revealed in patients already having ischemic heart disease.

Conclusion. Primary and secondary drug prevention of AMI in both registries did not meet modern clinical guidelines. This was especially true for patients with already established ischemic heart disease and to the greatest extent, according to both registries, refers to drugs from the statin group.

1. Martsevich S.Yu., Semenova Yu.V., Kutishenko N.P., Ginzburg M.L. at al. LIS-3 Register of the Acute Coronary Syndrome: what has Changed in a "Portrait" of a Patient and Short-Term Outcomes of the Disease Compared to LIS-1 Register. Rational Pharmacotherapy in Cardiology. 2017;13(1):63-8. (In Russ.) [Марцевич С.Ю., Семенова Ю.В., Кутишенко Н.П., et al. Регистр острого коронарного синдрома ЛИС-3: что изменилось за прошедшие годы в ≪портрете≫ больного и ближайших исходах заболевания в сравнении с регистром ЛИС-1. Рациональная Фармакотерапия в Кардиологии. 2017;13(1):63-8]. doi: 10.20996/1819-6446-2017-13-1-63-68.

2. Martsevich S.Yu., Semenova Y.V., Kutishenko N.P., Ginzburg М.L. Assessment of patients’ attendance at outpatient clinics and prehospital therapy: Russian acute coronary syndrome registry LISS-3 data. Indian Heart J. 2017;69(1):105-6. doi:10.1016/j.ihj.2016.11.005.

3. Semenova Y.V., Zagrebelnyy A.V., Kutishenko N.P.., et al. Assessment of changes in quality of prehospital treatment of patients with acute coronary syndrome in the last few years: LIS-1 vs LIS-3 registries. Rational Pharmacotherapy in Cardiology. 2017;13(6):827-34. (In Russ.) [Семенова Ю.В., Загребельный А.В., Кутишенко Н.П., и др. Оценка динамики качества догоспитальной терапии больных с острым коронарным синдромом за прошедшие годы: сравнение регистров ЛИС-1 и ЛИС-32017. Рациональная Фармакотерапия в Кардиологии. 2017;13(6):827-34]. doi:10.20996/1819-6446-2017-13-6-827-834.

4. Sundbøll J., Schmidt M., Horvбth-Puhу E., et al. Impact of preadmission treatment with calcium channel blockers or betablockers on short-term mortality after stroke: a nationwide cohort study. BMC Neurol. 2015;15(1):24. doi:10.1186/s12883-015-0279-3.

5. Martsevich S.Yu., Semenova Yu.V., Kutishenko N.P., et al. Assessment of patients compliance for ambulatory institutions visitsand its influence on the quality of treatment before development of acute coronarysyndrome, by the LIS-3 registry. Russ J Cardiol. 2016;6(134):55-60. (In Russ.) [Марцевич С.Ю., Семенова Ю.В., Кутишенко Н.П., и др. Оценка приверженности пациентов к посещению лечебно-профилактических учреждений и ее влияния на качество терапии до развития острого коронарного синдрома в рамках регистра ЛИС-3. Российский Кардиологический Журнал. 2016;6(134):55-60. doi: 10.15829/1560-4071-2016-6-55-60.

6. SemenovaY.V., Kutishenko N.P., Zagrebelnyy A.V., et al. Influence of patients’ prehospital attendance at outpatient clinics on long-term outcomes of acute coronary syndrome: LIS-3 STUDY. Rational Pharmacotherapy in Cardiology. 2017;13(3):363-369. doi:10.20996/1819-6446-2017-13-3-363369.inRussianСеменова Ю.В., Кутишенко Н.П., Загребельный А.В., Гинзбург М.Л., Деев А.В., Марцевич С.Ю. Влияние догоспитальной приверженности пациентов к посещению лечебнопрофилактических учреждений на отдаленные исходы острого коронарного синдрома: исследование ЛИС-3. Рациональная Фармакотерапия в Кардиологии. 2017;13:363-9.

7. Yusuf S., Islam S., Chow C.K., et al. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. Lancet. 2011;378(9798):1231-43. doi: 10.1016/S01406736(11)61215-4.

8. Lee H.Y., Cooke C.E., Robertson T.A. Use of Secondary Prevention Drug Therapy in Patients With Acute Coronary Syndrome After Hospital Discharge. J Manag Care Pharm. 2008;14(3):271-80. doi:10.18553/jmcp.2008.14.3.271.

9. Gorelick P.B., Goldstein L.B., Ovbiagele B. New guidelines to reduce risk of atherosclerotic cardiovascular disease: implications for stroke prevention in 2014. Stroke. 2014 Apr;45(4):945-7. doi: 10.1161/STROKEAHA.114.004560.