Malaysia-ACute CORonary syndromes Descriptive study (ACCORD): evaluation of compliance with existing guidelines in patients with acute coronary syndrome

Ahmad WAW, Ramesh SV, Zambahari R
Correspondence: Prof Wan Azman Wan Ahmad, wanazman@ummc.edu.my

ABSTRACT
Introduction The ACute CORonary syndromes Descriptive study (ACCORD ) is a prospective observational study that evaluates the management of acute coronary syndrome (ACS) in clinical practice and the use of antiplatelet agents in acute settings and after discharge. The secondary objective of this study was to obtain information on risk factors in a large cohort of patients with ACS.
Methods The study population included subjects aged at least 21 years who had unstable angina or non-ST elevation myocardial infarction. The patients had four follow-up visits over a one-year period.
Results A total of 525 patients from Malaysia were enrolled into the study. The mean age of the patients was 58.14 +/− 11.3 years, and the mean body mass index was 25.4 +/− 4.3 kg/m2. 96.8 percent of subjects had at least one cardiovascular risk factor. Following hospitalisation, 83.6 percent of patients were managed medically. During the follow-up visits, 62.7–77.6 percent of patients received aspirin only, 5.0–6.8 percent received clopidogrel only and 15.6–32.3 percent received dual antiplatelet medications. Compliance with aspirin was 93.5–96.5 percent. Clopidogrel compliance was above 80 percent of the prescribed tablets for more than 88 percent of patients.
Conclusion Patients in the Malaysia-ACCORD registry were much younger compared to those in the Global Registry of Acute Coronary Events. The majority of patients had cardiovascular risk factors at presentation and were treated medically, and those on dual antiplatelet therapy had a relatively high level of compliance.

Keywords: acute coronary syndrome, antiplatelets, compliance, guidelines
Singapore Med J 2011; 52(7): 508-511