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Implications of prescribing a fixed-dose combination in clinical cardiology practice: a retrospective observational study using a single medical centre database in Korea

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Author(s)
Hyungseop KimHyuck-Jun YoonHyoung-Seob ParkYun-Kyeong ChoChang-Wook NamSeongwook HanSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Kim, Yoon NyunPark, Hyoung SeobKim, Hyung SeopHur, Seung HoYoon, Hyuck JunNam, Chang WookCho, Yun KyeongHan, Seong WookKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Heart Asia
Issued Date
2017
Volume
9
Issue
2
Keyword
AdherenceFixed-dose combinationPrognosis.
Abstract
Objective Fixed-dose combination (FDC) prescribing
enhances adherence to medication. However, there
are limited data regarding the usefulness of FDC drugs
across different risk groups. The aim of this study was to
explore the relationship between FDC discontinuation
and clinical outcomes.
Methods From January 2008 to December 2014,
patients with FDC prescriptions who visited a cardiology
outpatient clinic at a tertiary university hospital in Daegu,
Republic of Korea were retrospectively identified. The
10-year atherosclerotic cardiovascular disease (ASCVD)
risk score and 20 conventional cardiovascular (CV) risk
factors were assessed. Patients were classified according
to FDC continuation, together with a tertile of 20 risks.
CV events were defined as the composite of admission
for worsening heart failure or diabetes, stroke, ischaemic
heart disease, and CV death.
Results 502 patients were prescribed with one of the
following FDC products: calcium channel blocker (CCB)
plus angiotensin receptor blockers (ARB), CCB plus
statins, and ARB plus diuretics. During follow-up (mean
2.8±2.4 years), 203 discontinuations (40.4%) occurred.
FDC-discontinued patients had lower ASCVD risk scores
(24.8% vs. 28.8%, p<0.001), and patients with <6 risk
factors discontinued FDC frequently. During follow-up,
57 events (11.4%) were reported: 30 (14.8%) in FDCdiscontinued
patients and 27 (9.1%) in FDC-continued
patients (p=0.062). In multivariate models accounting for
events, FDC discontinuation (p<0.001) and high ASCVD
risk score (p=0.017) were associated with CV events.
Conclusions FDC discontinuation was common among
patients attending the cardiology outpatient clinic. Our
analyses suggest that FDC discontinuation in patients at
high ASCVD risk may have an impact on CV event rates.
Keimyung Author(s)(Kor)
김권배
김윤년
김형섭
윤혁준
박형섭
조윤경
남창욱
한성욱
허승호
Publisher
School of Medicine
Citation
Hyungseop Kim et al. (2017). Implications of prescribing a fixed-dose combination in clinical cardiology practice: a retrospective observational study using a single medical centre database in Korea. Heart Asia, 9(2), e010885–e010885. doi: 10.1136/heartasia-2017-010885
Type
Article
ISSN
1759-1104
DOI
10.1136/heartasia-2017-010885
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32414
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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