Prescribing Pattern of Cardiovascular Drugs and Quality of Life in Myocardial Infarction Patients: An American Heart Association-based Evaluation

Objectives: Despite the extensive use of guideline-directed medical therapy for myocardial infarction (MI), the prescribing pattern tends to stray from the protocol due to various factors. A plethora of studies have focused on assessing the efficacy of individual medications to improve the outcome, research on examining prescribing patterns, the adherence of the latter with the standard American Heart Association (AHA) guidelines, and its impact on health-related quality of life remains insufficient. MI is commonly referred to as a heart attack which occurs due to ischemia to the heart muscles and it accounts for 17 million deaths every year. Our study aims to bridge this gap, optimize therapeutic strategy, and also enhance patient-centered care. Material and Methods: A prospective observational study was conducted in the Department of Cardiology at Karpagam Faculty of Science and Research in Coimbatore, Tamil Nadu. This study included myocardial infarction patients for a period of 6 months. Demographic and clinical data were collected using structured case sheets and the Euro Qol (EQ)-5D-3L questionnaire. Results: A total of 140 MI patients were enrolled in the study, with a clear male predominance (68.13%) and the majority aged between 50 and 70 years. Hypertension (36.45%) and diabetes mellitus (24.34%) were the most commonly observed comorbidities. On analyzing the prescribing pattern of cardiovascular drugs used in Myocardial Infarction patients which are considered the core cardiovascular therapies. Antiplatelets such as aspirin (100%) and ticagrelor (83.1%) were most commonly prescribed. Heparin (84.1%) was the most predominant anticoagulant and statins such as rosuvastatin (11.9%) and atorvastatin (4.5%) were frequently used. Nitroglycerine trinitrate (13.3%) and cilnidipine (12.6%) were the commonly prescribed antihypertensives. On comparing the prescribing pattern with standard AHA guidelines, the core cardiovascular therapy showed good adherence toward the guidelines. Quality of life assessment using the EQ-5D-3L questionnaire indicates a significant association of antiplatelets ( P = 0.000), anticoagulants ( P = 0.035), and statins ( P = 0.018) with various health domains, whereas antihypertensives did not demonstrate a significant correlation ( P = 0.734). Conclusion: This study demonstrates that prescribing patterns in MI patients showed good adherence toward the standard AHA guidelines. Comparison of prescribing patterns with quality of life revealed a significant correlation for antiplatelets, anticoagulants, and statins, while antihypertensives demonstrated no significant impact.