Medications Recommended for Secondary Prevention After First Acute Coronary Syndrome: Effectiveness of Treatment Combinations in a Real-Life Setting. : Clin Pharmacol Ther

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Bezin, Julien | Klungel, O. H. | Lassalle, R. | Dureau-Pournin, C. | Moore, Nicholas | Pariente, Antoine

Edité par CCSD ; American Society for Clinical Pharmacology and Therapeutics -

International audience. Long-term effectiveness of Evidence-Based Cardiovascular Medications (EBCMs) indicated after Acute Coronary Syndrome (ACS) needs to be assessed considering the combination effects for these drugs recommended in association. Using a nationwide database, we conducted a cohort study to evaluate the effectiveness of all possible incomplete EBCMs-based combinations as compared to that associating the four recommended EBCMs over up to five years of follow-up. Among the 31,668 patients included, 22.9% had ACS recurrence or died during follow-up. The risks associated with the use of 3-EBCM based combinations were 1.46 (95% confidence interval: 1.33-1.60) for the combinations without statins, 1.30 (1.17-1.43) for the combinations without angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 1.11 (0.98-1.25) for the combinations without antiplatelet agents, and 0.99 (0.89-1.10) for the combination without beta-blockers. These findings question the interest of maintaining long-term treatment with beta-blockers in addition to the other EBCMs for post-ACS secondary prevention. This article is protected by copyright. All rights reserved.

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