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Predictors and Prevalence of Proton Pump Inhibitor (PPI) Prescribing in Acute Coronary Syndrome (ACS)
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| Author:
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, WARDATI MAZLAN-KEPLI, LAI WAN MAE, ABDUL MUIZZ ABDUL MALEK, CHIA CHUN HOU, WINNIE NEOH TZE SHIN
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| Abstract:
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Background: Proton pump inhibitor (PPI) is recommended for patients on dual antiplatelet (DAPT) therapy
with a history of prior gastrointestinal bleeding and those with multiple risk factors for GI bleeding. Several
studies revealed that a large proportion of patients had no evidence-based indication for using PPI. However,
there is a research gap in PPI prescribing among acute coronary syndrome (ACS) patients in Malaysia. This
study aimed to determine the prevalence of PPI prescribing among ACS patients in Hospital Serdang and the
predictors of PPI prescribing in this population.
Results: Out of 467 patients (77.5 % male; mean age 57.0 (12.5) years), 36.4% (n=170) were prescribed with
PPI during hospitalization. Of the 436 patients (77.1% male; mean age 56.7 (12.5) years) who were successfully
discharged, 37.8% (n=165) were prescribed with PPI at discharge. Predictors of PPI during hospitalization and
at discharge were similar including types of ACS in relation to unstable angina i.e. ST-elevation myocardial
infarction (MI), low hemoglobin during admission and medicated with PPI before admission. On the other
hand, concomitant anticoagulant, antiplatelet and DAPT were not predictors of PPI during hospitalization and
at discharge.
Conclusion: The prescribing of PPI during hospitalization and at discharge following ACS is modest, although
it increased based on the type of MI, low hemoglobin during admission and whether patient was previously
prescribed with PPI. We suggest larger studies to identify bleeding risks, and to explore practitioners’
awareness on PPI prescribing to optimize PPI prescriptions in future.
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| Keyword:
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proton pump inhibitors, acute coronary syndrome, predictors, discharge.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.02.404
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| Download:
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