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Utilization of evidence-based secondary preventive therapies post-acute coronary syndrome: a heart registry cohort

Anthony Ochola1, Jasmit Shah1,2, Mohamed Jeilan1

  • 1Department of Medicine, Aga Khan University, Nairobi, Kenya.

The Pan African Medical Journal
|June 22, 2026
PubMed

Insights

Secondary prevention medication use after acute coronary syndrome (ACS) in Kenya was low pre-hospital but improved at discharge. Interventions are needed to enhance long-term adherence to guideline-directed therapy post-ACS.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacotherapy

Background:

  • Cardiovascular disease, particularly coronary artery disease, is a leading cause of mortality in Africa.
  • Secondary prevention post-acute coronary syndrome (ACS) is crucial but often suboptimal in low- and middle-income countries.
  • International guidelines recommend antiplatelet agents, statins, beta blockers, and ACE inhibitors for secondary prevention post-ACS.

Purpose of the Study:

  • To quantify the use of guideline-recommended secondary prevention medications after ACS in Kenya.
  • To identify patterns and predictors of medication use at discharge following ACS.
  • To assess the gap between recommended and actual secondary prevention therapy in a Kenyan cohort.

Main Methods:

  • A cohort study utilizing data from the Kenya Heart Registry (2019-2023).
  • Inclusion of adult patients diagnosed with ACS (STEMI, NSTEMI, or UA).
  • Extraction of clinical, sociodemographic, and pharmacotherapy data; analysis using descriptive statistics and multivariate logistic regression.

Main Results:

  • A total of 247 patients were analyzed; 77.7% were male, and 39.3% were over 65 years.
  • Secondary prevention medication use increased significantly from pre-hospital to discharge.
  • At discharge, aspirin (91.4%) and statins (88.3%) were highly utilized; beta-blocker and ARB use was associated with specific comorbidities.

Conclusions:

  • In-hospital and discharge prescribing patterns for ACS secondary prevention in Kenya show improvement.
  • Suboptimal pre-hospital medication use and underutilization of agents like ticagrelor persist.
  • Tailored interventions, including provider training and patient education, are essential for long-term adherence to guideline-directed medical therapy.
Abstract

Keywords:
Coronary artery diseaseacute coronary syndromedrug therapysecondary prevention

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