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Aldosterone Antagonists in ST Elevation Myocardial Infarction Patients with Low Left Ventricular Ejection Fraction: a Retrospective Study at Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal
Chandra Mani ADHIKARI, Sujeeb RAJBHANDARI, Dipanker PRAJAPATI, Nagma SHRESTHA, Bibek BANIYA, Amrit BOGATI, Prakash GURUNG and Suman THAPALIYA
ABSTRACT
Background: Aldosterone antagonists (AA) improve survival in ST elevation myocardial infarction (STEMI) patients with left ventricular ejection fraction(LVEF) ≤40% ,with either clinical heart failure or diabetes mellitus. Our aim was to assess the adherence of AA use in Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
Methods: Medical records of 171 STEMI patients with LVEF ≤40% and discharged from our centre between January 2012 and December 2012 were retrospectively reviewed, regarding the use of AA use.
Results: Among the 171 STEMI patients with LVEF ≤40%, 5 patients were excluded study due to the presence of contraindication to AA therapy. Among the remaining 166 patients, only 135 (81.2%) patients were eligible for the AA therapy (58 patients with diabetes mellitus and clinical heart failure in 77 patients). Out of 58 diabetes mellitus patients, 28 (48.2%) patients were treated with AA. Whereas 39(50.6%) out of 77 patients with clinical heart failure were treated with AA. Overall, 67(49.6%) patients among 135 eligible patients were treated with AA.
Conclusions: As in the international studies AA is under-used in our patient population. We still need some more effort to improve our prescription rate.
Keywords: aldosterone antagonist, heart failure, myocardial infarction