Pattern of Pharmacotherapy of Patients Having Ischemic Heart Disease at a Specialized Hospital in Dhaka, Bangladesh: A Survey Based Study on Patients Discharged from Hospital

Abstract

Aims: Study on pharmacotherapeutic pattern on cardiovascular patients is rarely done. Patient’s demography, drug usage and its clinical outcome are the basis for the assessment of cardiac treatment. The aim of this study to analyze the demography of patients of ischemic heart disease along with drug usage and current trends of practice in Bangladesh. Methods: This study was carried out over a period of two months at different units of NICVD, situated at Dhaka, Bangladesh. A structured questionnaire was prepared to collect necessary data from patients. Descriptive statistics was used to represent the data. Results: A total 363 discharged patients were interviewed followed by the verification of their discharge report and other medical documents to obtain necessary information. Out of 363 patients, frequency of male patients were high (74.66%, N= 271) than female patients (25.34%, Original N=92). There is a trends of ischemic heart disease development after 40 years of age and found significant in this study ( P< 0.05 ). In this study, 83.19% of total patients were above 40 years of age. We found a significant number of patients also had diabetes, asthma and chronic kidney disease. Treatment approach of ischemic heart disease includes pharmacotherapy, revascularization and percutaneous coronary intervention. 48 patients (13.22%) out of 363 went for revascularization and percutaneous coronary intervention was done to 25 patients (6.89%). The goal of Pharmacotherapy is to reduce blood cholesterol level, prevention of further platelet aggregation, reduction of angina and control of heart rate. In our study, we found that, statins, anti platelet and anti angina/anti ischemic drugs are core in the treatment of ischemic heart disease. Beta blocker, ACE inhibitor or ARB, CCB is commonly added to standard therapy to reduce mortality and for better therapeutic outcome. Among statins, the frequency of use of atorvastatin (87.93%), combination of clopidogrel and aspirin (73.90%) among anti platelet agents, combination of trimetazidine and nitroglycerine (61.56%) among anti angina/anti ischemic agents were highest. In our study, we found that bisoprolol was most commonly prescribed by the physicians among other beta blockers. Conclusion: The outcome of this study will be helpful for young professionals, general physicians and other professionals involved in the health care setting for the rational use of drugs and to formulate effective strategy for the management of ischemic heart disease.