RESEARCH ARTICLE
Impact of Prior Use of Four Preventive Medications on Outcomes in Patients Hospitalized for Acute Coronary Syndrome– Results from CPACS-2 Study Min Li1☯, Yubei Huang2☯, Xin Du3,4, Shenshen Li3, Jiachao Ji3, Anushka Patel5, Runlin Gao6, Yangfeng Wu1,3*
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OPEN ACCESS Citation: Li M, Huang Y, Du X, Li S, Ji J, Patel A, et al. (2016) Impact of Prior Use of Four Preventive Medications on Outcomes in Patients Hospitalized for Acute Coronary Syndrome–Results from CPACS-2 Study. PLoS ONE 11(9): e0163068. doi:10.1371/ journal.pone.0163068 Editor: Yoshiaki Taniyama, Osaka University Graduate School of Medicine, JAPAN Received: July 8, 2016 Accepted: September 1, 2016 Published: September 14, 2016 Copyright: © 2016 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The source of funding used to support the CPACS-2 study is from Sanofi, China, through an unrestricted research grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: Both studies are funded by Sanofi, China. No author is an employee or consultant of Sanofi, or has any interests related to products of Sanofi. This does not alter the authors'
1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China, 2 Department of Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, 3 The George Institute for Global Health at Peking University Health Science Center, Beijing, China, 4 Beijing Anzhen Hospital, Capital Medical University, Beijing, China, 5 The George Institute for Global Health, University of Sydney, Sydney, Australia, 6 The Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bejing, China ☯ These authors contributed equally to this work. *
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Abstract Background It is widely reported that long-term use of four preventive medications (antiplatelet agents, angiotensin converting enzyme inhibitor / angiotensin receptor blocker, statin and betablockers) reduce the risk of subsequent acute coronary syndromes (ACS). It is unclear whether these four medications benefit patients who develop ACS despite its use.
Methods and Results Logistic regression and propensity-score was applied among 14790 ACS patients to assess the association between prior use of four preventive medications and in-hospital outcomes including severity of disease at presentation (type of ACS, systolic blood pressure = 100 beats/min), complicating arrhythmia and major adverse cardiovascular events (MACEs, including all deaths, non-fatal myocardial infarction or reinfarction, and non-fatal stroke). Prior use of each of the four medications was significantly associated with less severity of disease (ORs ranged from 0.40 to 0.82, all P
