Antiplatelet Therapy in Patients with Unstable Angina and Non-ST-Segment-Elevation Myocardial Infarction: Findings from the CRUSADE National Quality Improvement Initiative

Michael B. Bottorff, Pharm.D.; Edith A. Nutescu, Pharm.D.; Sarah Spinler, Pharm.D.

Disclosures

Pharmacotherapy. 2007;27(8):1145-1152. 

In This Article

Association Between Rates of Early and Discharge Antiplatelet Therapy

Analysis of high-risk patients (those with positive cardiac biomarkers or ischemic ST segment changes on ECG) from the CRUSADE initiative indicates that early antiplatelet use is associated with discharge drug use.[59] Patients who received aspirin immediately after arriving at an emergency department had an aspirin treatment rate of 91.6% at discharge. Those who received aspirin within the first 24 hours of presentation (but not immediately) had a treatment rate of 91.3% at discharge. However, those who did not receive early aspirin therapy had an aspirin treatment rate of just 53.3% at discharge (p<0.0001 vs patients receiving immediate or early aspirin therapy).

Similarly, an analysis of 10,868 patients showed that clopidogrel treatment rates at discharge were similarly associated with early clopidogrel treatment patterns; eligible patients who did not receive clopidogrel as an early drug intervention were less likely to be prescribed clopidogrel at discharge.[59] Discharge prescription rates for patients treated with clopidogrel immediately, within 24 hours, or not at all in the early phase of presentation with unstable angina or NSTEMI were 86.5%, 91.7%, and 37.9%, respectively (p<0.0001).

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