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Implications of prescribing a fixed-dose combination in clinical cardiology practice: a retrospective observational

Hyungseop Kim1, Hyuck-Jun Yoon1, Hyoung-Seob Park1

  • 1Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.

Heart Asia
|February 23, 2018
PubMed

Insights

Fixed-dose combination (FDC) drug discontinuation was common, especially in lower-risk patients. Discontinuing FDC medications in high atherosclerotic cardiovascular disease (ASCVD) risk individuals may increase cardiovascular event rates.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Fixed-dose combination (FDC) prescribing improves medication adherence.
  • Limited data exist on FDC usefulness across diverse patient risk groups.
  • Understanding FDC discontinuation's impact on clinical outcomes is crucial.

Purpose of the Study:

  • To investigate the association between FDC discontinuation and cardiovascular (CV) events.
  • To explore FDC discontinuation patterns in relation to patient risk stratification.

Main Methods:

  • Retrospective analysis of 502 patients with FDC prescriptions from cardiology outpatient clinics (2008-2014).
  • Assessment of 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores and 20 CV risk factors.
  • Classification of patients by FDC continuation status and ASCVD risk tertiles. CV events defined as composite of specific adverse outcomes.

Main Results:

  • 40.4% of patients discontinued FDC therapy during follow-up (mean 2.8 years).
  • FDC discontinuation was more frequent in patients with lower ASCVD risk scores (<6 risk factors).
  • FDC discontinuation (p<0.001) and high ASCVD risk (p=0.017) were independently associated with increased CV events.

Conclusions:

  • FDC discontinuation is a frequent occurrence in cardiology outpatient settings.
  • Discontinuation of FDC therapy in high ASCVD risk patients may elevate CV event rates.
  • Further research is needed to optimize FDC use in various cardiovascular risk strata.
Abstract

Keywords:
AdherenceFixed-dose combinationPrognosis.

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