Patterns of medication use and potential drug-drug interactions in post-PCI patients: A study from Iran

Post-percutaneous coronary intervention (PCI) patients often require complex medication regimens to prevent adverse cardiovascular events. However, these regimens can lead to potential drug-drug interactions (pDDIs) and polypharmacy, posing significant clinical challenges. This study aims to evaluate the pattern of medication use, prevalence, and correlates of pDDIs and polypharmacy among post-PCI patients in Shiraz, Iran.

A cross-sectional study was conducted on 9019 PCI patients in Shiraz. Patient data, including demographics, medical history, and medication lists, were collected and analyzed. The Anatomical Therapeutic Chemical (ATC) classification system was applied. pDDIs were identified using the Lexicomp database, and their severity was classified. Factors associated with significant pDDIs and polypharmacy were assessed using multivariable modeling.

The study found that 91.6 % of patients received statin prescriptions and 94.5 % were on antiplatelet therapy. Notably, 82.8 % were identified with at least one pDDI, with 80.4 % having significant interactions (Categories C, D, or X). Common potential interactions included aspirin with clopidogrel and rosuvastatin. Polypharmacy was prevalent in 73.6 % of patients, associated with higher risks of interactions. Factors such as polypharmacy, male gender, diabetes mellitus, and heart failure were significant predictors of pDDIs.

The study underscores the high prevalence of pDDIs and polypharmacy among post-PCI patients, revealing a critical gap between clinical guidelines and drug interaction databases. Updating interaction databases to reflect current clinical practices and enhancing collaboration between database developers and guideline authors are essential for improving medication safety and patient outcomes.