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

Adherence to Dosing Recommendations

Data from the CRUSADE initiative indicate that a significant proportion of patients (42%) received doses of antiplatelet and antithrombotic agents that exceeded the recommended dose.[63] Among 30,136 patients at 387 centers, doses of low-molecular-weight heparin, unfractionated heparin, and GP IIb-IIIa inhibitors outside the recommended range were administered at least once to 13.8%, 32.8%, and 26.8% of patients, respectively. Higher rates of major bleeding, increased mortality rates, and longer durations of hospitalization were also observed among patients receiving excess doses of these agents, compared with those treated with doses within the recommended ranges. Of note, along with women and patients older than 65 years, patients with renal insufficiency were among those most likely to receive excess doses of GP IIb-IIIa inhibitors (OR 4.12, 95% CI 2.95−5.75).

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