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Optimal medial therapy and percutaneous coronary intervention for stable angina: why patients should ‘be taking’ and ‘keep taking’ the tablets
Author(s) -
Mohee K.,
Wheatcroft S. B.
Publication year - 2014
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12164
Subject(s) - conventional pci , medicine , percutaneous coronary intervention , coronary artery disease , myocardial infarction , revascularization , angina , randomized controlled trial , cardiology , unstable angina , intensive care medicine
Summary What is known and objective Cardioprotective drug regimens improve outcomes in patients with stable coronary artery disease. Revascularization is recommended for the persistence of symptoms despite optimal medical therapy ( OMT ) or in patients likely to derive prognostic benefit. Our objective is to comment on recent evidence that initiation of OMT is suboptimal in patients undergoing percutaneous coronary intervention ( PCI ) but conversely adherence to medication may be higher in patients treated with PCI . Comment Large randomized controlled trials demonstrate that the risk of death or myocardial infarction is similar in patients treated by OMT alone and those treated with PCI and OMT . Despite the recommendations of international practice guidelines, OMT remains underutilized in recent analyses of patients referred for PCI . Notwithstanding the underutilization of proven therapies, a recent study suggests that adherence to medication is significantly higher in patients treated with PCI than in those treated with OMT alone. We discuss the potential factors that may contribute to underprescription of OMT and predict adherence in patients undergoing PCI . What is new and conclusion Contemporary studies continue to demonstrate underutilization of OMT in patients referred for PCI but increased medication adherence in patients treated by PCI . We argue for increased recognition of OMT as the definitive treatment for stable angina, so that we can be sure those patients who require PCI ‘are taking’ and ‘keep taking’ the tablets.