Pharmacy Practice

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Browsing Pharmacy Practice by Author "Assefa,Tamrat(Ass. Prof.)"

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    Clinical Outcomes and Associated Factors in Patients Who Successfully Underwent Percutaneous Coronary Intervention: A 5-Year Multicenter Retrospective Crossectional Study
    (Addis Ababa University, 2023-10) Melesse,Wondimu; Assefa,Tamrat(Ass. Prof.); Alemayehu,Bekele(Ass. Prof.)
    Background: Myocardial infarction (MI) is the leading cause of death globally, with the majority of death occurring in low-and middle-income countries (LMICs). Percutaneous coronary intervention (PCI) became a standard management modality to improve patients’ quality of life and reduce mortality when combined with pharmacologic therapy. However, the PCI service was not well-practiced in Ethiopian health facilities and also poor outcomes had previously been reported. Objective: To assess the clinical outcomes and associated factors among myocardial infarction patients who underwent successful PCI in Addis Ababa, Ethiopia. Methods: A retrospective crossectional study was conducted at three healthcare facilities from March 01 to May 31, 2022. A total of 241 MI patients who underwent successful PCI between January 1, 2017, and December 31, 2021, were included. The outcome measures were in-hospital mortality, non-fatal major adverse cardiac and cerebrovascular events (MACCEs) and complication rates. Data were analyzed using SPSS version 21.0. Multivariable Cox-regression was carried out to identify predictors of in-hospital mortality. Variable with p -a value < 0.05 was considered statistically significant. Kaplan Meier analyses were also used to determine overall survival rates and median survival time. Results: Out of 241 participants, 194 (80.5%) were males and the mean age was57.2 ± 10.6 years. One hundred eight-three (75.9%) patients had ST-elevated myocardial infarction (STEMI). Dyslipidemia 198 (82.2%) was the leading risk factor for MI. One twenty three (51%) patients received pharmaco-invasive PCI and drug-eluting stent (DES) implantation (181, 75.1%) was the most commonly used reperfusion method in the study settings. The most commonly used medications in these patients were statins (100%) and aspirin (92.6%), followed by clopidogrel (88.4%). In-hospital mortality and non-fatal MACCEs rates were 3.7% and 24.1%, respectively. The predictors for in-hospital mortality were being female (AHR=8.39, 95% CI: 1.20-58.68, P= 0.03), pre-procedural obesity (AHR=6.54, 95% CI: 1.10-40.60, P=0.04), previous MI (AHR=9.68, 95% CI: 1.66-56.31, P=0.01), chronic heart failure (AHR=9.21, 95% CI: 1.38-61.78, P=0.02) and having previous history of stroke (AHR=18.99, 95% CI: 1.59-227.58, P=0.02). The overall estimated 1-year survival rate of MI patients who underwent successful PCI was 96.3%. Conclusion and recommendation: Pharmaco-invasive PCI was the most commonly deployed intervention in patients with myocardial infraction. The overall in-hospital mortality rate was low and about a quarter of study patients developed non-fatal MACCEs. The estimated one-year survival rate was higher. Although the current study's findings appear to be better, there is still improvement to be made in terms of providing essential medications, proper documentation of patient data, and expanding access of reperfusion therapy in the country