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Appropriate use of antiplatelets: is prescription in daily practice influenced by the global cardiovascular risk?

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the appropriate prescription of antiplatelets according to patients’ global cardiovascular risk level in everyday practice.

Methods

In a cross-sectional study, general practitioners (GPs) identified a random sample of 10% of patients at cardiovascular risk among all subjects coming to the surgery and collected data on cardiovascular risk factors and history of atherosclerotic cardiovascular diseases (CVD). GPs were asked to do a physical examination and record the results of laboratory tests to define the global cardiovascular risk. The use of antiplatelet drugs in patients with established CVD and in healthy subjects at high risk of developing symptomatic atherosclerotic disease was evaluated.

Results

A total of 162 GPs from all over Italy recruited 3,120 subjects (51% female, mean age 64 years). Of the 949 with an indication for antiplatelet treatment for secondary prevention of CVD, 442 (47%) were receiving it. Among the 2,071 without CVD, 11% were taking an antiplatelet drug. In this group, antiplatelets were prescribed in 6, 10, 16 and 23%, respectively, of patients perceived by GPs to be at mild, moderate, high and very high cardiovascular risk.

Conclusions

Prescription of antiplatelets still seems to be far from what is recommended in virtually all patients with a history of CVD. In subjects with cardiovascular risk factors but without CVD antiplatelet prescription increases in relation to global cardiovascular risk but is still low in patients at high or very high risk of cardiovascular events.

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Acknowledgements

We would like to thank Dr. Vittorio Bertele’ for helpful comments on the manuscript, Fiorenza Clerici, Guya Sgaroni and Angela Palumbo for careful secretarial assistance in the management of the study and in preparing the paper, and Judith Baggott for editorial assistance. An educational grant was provided by Pharmacia Upjohn and Società Prodotti Antibiotici (SPA) for the coordination expenses.

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Authors and Affiliations

  1. Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea 62, 20157, Milano, Italy

    Lara Monesi, Fausto Avanzini, Simona Barlera, Davide Lauri, Daria Roccatagliata, Gianni Tognoni & Maria Carla Roncaglioni

  2. CSeRMEG Centro Studi e Ricerca in Medicina Generale, Monza, Italy

    Vittorio Caimi & Massimo Tombesi

  3. CoS Consorzio Sanità, Milano, Italy

    Paolo Longoni

Authors
  1. Lara Monesi
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  2. Fausto Avanzini
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  3. Simona Barlera
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  4. Vittorio Caimi
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  5. Davide Lauri
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  6. Paolo Longoni
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  7. Daria Roccatagliata
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  8. Massimo Tombesi
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  9. Gianni Tognoni
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  10. Maria Carla Roncaglioni
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Corresponding author

Correspondence to Maria Carla Roncaglioni.

Additional information

The authors wrote this article on behalf of the Collaborative Group Risk and Prevention Study. A full list of investigators is reported in the Appendix.

conflict of interest: none

Appendix

Appendix

General practitioners

Adinolfi D. (Pozzuoli); Agneta A. (Montalbano Jonico); Alberino S. (Chiusdino); Alexanian A. (Milano); Anglano B. (Parona-Verona); Aronica A. (Milano); Bagagli F. (Torino); Balzan C. (Trichiana); Barba G. (Talsano); Baron P. (Palmanova); Barone A. (Albano di Lucania); Bedon R. (Casale Monferrato); Benetti R. (Casale sul Sile); Berton G. (Castelfranco Veneto); Besozzi E. (Castelletto sopra Ticino); Bevilacqua S. (Viterbo); Bizzarri G. (Cannara); Boldini L. (Torbole Casaglia); Bonzi G. (Ostiano); Bosisio Pioltelli M. (Monza); Bozzetto R.M. (Breganze); Brocchi A. (Cortona); Brizzi A. (Terlizzi); Bruno B. (Montereale); Burbi M. (Cortona); Buzzatti A. (Sedico); Cadioli T. (Carpi); Caimi V. (Monza); Calciano F.P. (Grassano); Calienno S. (Monza); Caltagirone P. (Castelnuovo di Isola Vic.); Capelli O. (Montefiorino); Casella M. (Caserta); Casella P. (Caserta); Caso C. (Mercato San Severino); Cassanelli M. (Castelfranco Emilia); Catalano A. (San Leucio del Sannio); Ciociano C. (Sarno); Coazzoli E. (Milano); Colecchia G. (Massa); Colombo I. (Boffalora sul Ticino); Conti M. (Castiglion Fiorentino); Corti N. (Scandiano); Corvino P. (Caserta); Cotroneo S. (Villa San Giovanni); Cozzani L. (Ponte di Arcola); Cuffari A. (Marino); Cuozzo E. (Napoli); Cusmai L. (Foggia); D’Anna M.A. (Milano); Danti G. (Buttapietra); De Cesare G. (Caserta); De Maria E. (Napoli); De Maria R. (Milano); De Matteis D. (Belvedere Spinello); Del Carlo A. (Viareggio); Dell’Aquila A.M. (Caserta); De Sire G. (Caserta); Di Giovambattista E. (Magnano in Riviera); Di Giuseppe M. (Carnate); Dionette M.G. (Scano di Montiferro); Ermacora T. (Maiano); Fastidio M. (Milano); Ferrari V. (Parabita); Ferreri A. (Cigoli San Miniato Basso); Filippi S. (Pontremoli); Fortunato S. (Montoro Inferiore); Fossati B. (Monza); Fumagalli M.A. (Senago); Galimberti G. (Como); Galli G. (Licciana Nardi); Galopin T. (Verona); Gambarelli L. (Scandiano); Gangi F. (Pasian di Prato); Gardinale E. (Milano); Gasparin A. (Pordenone); Gasparri R. (Mansue’); Gelardi M. (Urbino); Gentile M. (Terni); Germano S. (Avola); Germini F. (Perugia); Giugliano R. (Pozzuoli); Guerra C. (Aprilia); Guerrini A. (Piangipane); Idone A. (Catona); Lattuada G. (Uboldo); Lippa L. (Avezzano); Lombardi P. (Milano); Longoni P. (Milano); Lorello M. (Napoli); Maggioni A. (Ala); Malavasi P. (Carpi); Manni A. (Scandiano); Mao M. (Torino); Marazzi M. (Mirandola); Mariangeloni A. (Terontola); Maruzzi G. (Cantù); Masperi M. (Abbiategrasso); Massa E. (Cittadella); Mastella M. (Foza); Mezzacapo G. (Veroli); Mingarelli C. (Aprilia); Mingione F. (Puccianiello); Minotta F. (Pozzuoli); Misiani V. (Reggio Calabria); Montecchio G. (Abbiategrasso); Moretti S. (Caserta); Morini M. (Cotignola); Moro A. (Preganziol); Nasorri R. (Terontola); Nicoli S. (Borgo di Terzo); Nicolosi M. (Torino); Orlando V. (Caserta); Paci C. (Gioia del Colle); Palatella A. (Foggia); Panigada M. (Bergamo); Panza E.G. (Bollate); Parini P.C. (Vittuone); Paroli G. (Galleno); Patafio M. (Scilla); Pedroni M. (Scandiano); Perone V. (Caserta); Perugini I. (Capranica); Petrera L. (Castellaneta); Piazza G. (Santorso); Piccolo F. (Bisceglie); Pignatti M. (S. Giovanni in Persiceto); Pinto D. (Monopoli); Pirovano E. (Milano); Pirrotta D. (Scilla); Pulcino Lupo G. (Caserta); Rafanelli P. (Firenze); Ramunni A. (Conversano); Recusani A. (Parma); Ribetto Bruno M. (Villar Perosa); Ricciarini P. (Lucignano); Rinchi F. (Cortona); Riva M.G. (Monza); Rossi C. (Casagiove); Rossi R. (Urbino); Rossitto A. (Taranto); Russo V. (Pozzuoli); Sagnelli C. (Maddaloni); Savignano L.C. (Casagiove); Scattolari G. (Urbino); Sissa F. (Virgilio); Sizzano E. (Trivero); Sproviero A.M. (Pozzuoli); Sproviero S. (Pozzuoli); Stranges M. (Caserta); Talia R. (Villa San Giovanni); Tedesco A. (Guradavalle); Titta G. (Torino); Tomba A. (Valdagno); Tosetti C. (Porretta Terme); Uberti M. (Torino); Vece R. (Eboli); Vincenti G. (Sarzana); Visentini E. (Sant’Angelo di Piove di Sacco); Vitali F. (Castiglione del Lago); Vitaloni E. (Abbiategrasso); Zannier P. (San Giuliano Milanese); Zappone P. (Palmi); Ziccardi F. (San Clemente); Zitiello V. (San Marco Evangelista); Zizzo F. (Lissone); Zorzi C. (Ziano di Fiemme).

Data management and statistics

Clerici F.1, Colombo F.1, Barlera S.1, Palumbo A.1, Sgaroni G.1

Scientific committee

Aronica A.2, Avanzini F.1, Caimi V.3, Lauri D.1, Longoni P.2, Marchioli R.4, Monesi L.1, Roccatagliata D.1, Roncaglioni MC.1, Tognoni G.1, Tombesi M.3, Visconti M.2

1 Istituto di Ricerche Farmacologiche “Mario Negri”, Milano; 2 CoS, Milano; 3 CSeRMEG, Monza; 4 Consorzio “Mario Negri Sud”, Santa Maria Imbaro.

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Monesi, L., Avanzini, F., Barlera, S. et al. Appropriate use of antiplatelets: is prescription in daily practice influenced by the global cardiovascular risk?. Eur J Clin Pharmacol 61, 595–601 (2005). https://doi.org/10.1007/s00228-005-0948-z

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  • DOI: https://doi.org/10.1007/s00228-005-0948-z

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