The impact of age and chronic kidney disease on secondary prevention post-primary percutaneous coronary intervention

D. Zachariah, R. Brown, P. Kanagala, A. Bashir, M. Mohan, P. Callan, R. Rajendra, A. L. Clark, I. Squire, M. Gunning, C. C. Lang, P. R. Kalra

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6 Citations (Scopus)


Historical data suggest elderly patients and those with chronic kidney disease (CKD) receive suboptimal secondary prevention following myocardial infarction (MI). We evaluated the impact of age and CKD on secondary prevention following primary percutaneous coronary intervention (PPCI) in a contemporary unselected cohort.|We studied 1169 consecutive patients from five UK centres receiving PPCI for ST elevation MI, with use of evidence-based secondary prevention at discharge assessed by age (75 years) and estimated glomerular filtration rate (eGFR). Follow-up prescribing practice was assessed in 567 patients.|One-fifth of patients receiving PPCI were >75 years. This group received fewer secondary prevention drugs at discharge compared to younger patients (P < 0.01 for β-blockers, angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and statins). By 6 weeks post-PPCI, there was a small drop-off in evidence-based therapy; β-blocker and statin use in those >75 years fell from 90% to 86% and 96% to 93%, respectively. CKD (eGFR60 ml/min/1.73 m(2)).|The uptake of secondary prevention medication is high following PPCI in the UK, even in the elderly and in those with renal dysfunction. A focus on strategies to improve up-titration and continuation of drugs following discharge is required.
Original languageEnglish
Pages (from-to)185-192
Number of pages8
Issue number3
Publication statusPublished - 2014


  • Adrenergic beta-Antagonists Age Factors Angiotensin Receptor Antagonists Angiotensin-Converting Enzyme Inhibitors Female Glomerular Filtration Rate Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors Male Middle Aged Myocardial Infarction Percutaneous Coronary Intervention Renal Insufficiency, Chronic Retrospective Studies Secondary Prevention Treatment Outcome


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