Sajjad Hussain, Azhar Mahmood Kayani, Rubab Munir.
Clopidogrel use - are we following the guide lines?.
Pak Heart J Jan ;48(2):65-70.

Objective: To see the prescription patterns of clopidogrel in the outpatient department of a tertiary care hospital. Methodology: This descriptive cross-sectional study was conducted at Armed Forces Institute of Cardiology and National Institute of Heart Diseases Rawalpindi, from 1st February 2012 to April 2012, after approval from Ethical review board of the institute. A structured team of MBBS doctors was created to conduct the study. Data on clopidogrel prescriptions was collected from the pharmacy where their source notes were assessed and patients taking clopidogrel were identified. Results: The study population consisted of 2263 patients. The age of patients ranged from 25 to 93 years with the mean of 60.45 years +- 9.969. The standard indications found for clopidogrel prescription included ST elevation MI (STEMI) in 582 (25.7%), Non-ST elevation MI (NSTEMI) in 130 (5.7%), percutaneous coronary interventions (PCI) in 703 (31.1 %), CABG in 300 (13.3%), stroke/TIA in 60 (2.6 %) and atrial fibrillation in 15 (0.66%). These standard indications constituted 79.09% of prescription. The duration of clopidogrel use ranged from 1 year to maximum of 10 years with mean of 3.38 +- 2.13 years. Patients who had suffered a NSTEMI 84.6%, and 84.3% who had suffered a STEMI more than 1 year ago were still receiving clopidogrel. Conclusion: We concluded that indications for which clopidogrel were prescribed to most patients were according to recommended international guidelines. But duration of its use is not according to guideline directed medical therapy.

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