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Drug–drug interactions in patients with acute coronary syndrome across phases of treatment

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Abstract

The objective of this study is to evaluate potential drug–drug interactions (pDDIs) and risk factors for pDDIs in three phases of an acute coronary syndrome (ACS) treatment: from the point of first medical contact to the coronary angiography (first phase), after coronary angiography to the last day of hospitalization (second phase), and at discharge from hospital (third phase). This retrospective observational cohort clinical study was conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Micromedex® interaction checker was used to detect pDDIs. This study included 245 ACS patients. All patients were exposed to at least one pDDI in all the phases of treatment. Mean total number of pDDIs was 9.47 ± 6.07, 10.11 ± 6.92, and 6.29 ± 3.66 in first, second, and third phases, respectively. Age, > 6 h from the beginning of the symptoms to admission, primary PCI, STE-ACS, COPD, delirium, hyperlipidemia, hypertension, obesity, systolic blood pressure at admission, TIMI risk score at admission, ALT, LDL, number of physicians who prescribed drugs to a single patient, number of prescribed drugs, and various pharmacological classes increased risk of pDDIs. Mechanical ventilation, dementia, and drug allergy noted in the medical documentation protected against them. Effects of heart failure, diabetes, and aPTT depended on phase of treatment and severity of pDDI. In conclusion, physicians should be vigilant to the possibility of pDDIs in patients harbouring factors that may increase their rate.

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Acknowledgements

This work was partially supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (grant number 175007). Ana V. Pejčić is awarded with the Scholarship of the Ministry of Education, Science and Technological Development of the Republic of Serbia for PhD students.

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Authors and Affiliations

  1. Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, Kragujevac, 34000, Serbia

    Ana V. Pejčić

  2. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, Kragujevac, 34000, Serbia

    Slobodan M. Janković

  3. Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovića 69, Kragujevac, 34000, Serbia

    Goran Davidović

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  1. Ana V. Pejčić
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Correspondence to Ana V. Pejčić.

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The authors declare that they have no conflict of interest.

Statement of human and animal rights

The Ethics Committee of the Clinical Centre Kragujevac approved the study prior to its initiation. All procedures performed in studies involving human participants are in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This is a retrospective study, and for this type of study, formal consent is not required.

Data availability statement

The data sets generated during or analyzed during the current study are available from the corresponding author on reasonable request.

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Pejčić, A.V., Janković, S.M. & Davidović, G. Drug–drug interactions in patients with acute coronary syndrome across phases of treatment. Intern Emerg Med 14, 411–422 (2019). https://doi.org/10.1007/s11739-018-1994-8

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  • DOI: https://doi.org/10.1007/s11739-018-1994-8

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