# Adherence to European Society of Cardiology guidelines at discharge after Acute Coronary Syndrome: a two-center data from Georgia

## TL;DR

This study examines how well hospitals in Georgia follow heart disease treatment guidelines after patients are discharged following a heart attack.

## Contribution

The study provides a detailed assessment of guideline adherence in Georgia for Acute Coronary Syndrome treatment post-discharge.

## Key findings

- Complete adherence to guideline-directed therapy was 74.5% with 89.7% when including documented contraindications.
- Adherence rates varied across drug classes, with the highest for ACE inhibitors/ARB and aspirin.
- Adherence was lower in NSTEMI patients and those receiving only medical treatment.

## Abstract

The aim of the study was to investigate the adherence to ESC guidelines in patients discharged after ACS in Georgia.

A prospective observational study was performed in 2 cardiac hospitals in Tbilisi from March 2021 till June 2022. A total of 428 consecutive patients with confirmed diagnosis of Acute Coronary Syndrome at discharge were evaluated. The primary outcome was defined as adherence to Guideline Directed Medical Therapy (GDMT) at discharge post-Acute Coronary Syndrome.

Complete guideline adherence for the combination of 5 medication classes was 74.5%, and additionally in 15.2% contraindications or intolerance were well documented, so the complete guideline adherence was very high − 89.7%. The guideline adherence for individual drug class differed from 98.9% for ACE inhibitors/ARB and acetylsalicylic acid to 92.9% for P2Y12 receptor inhibitor.

Adherence to GDMT according to the data received from 2 hospitals is promising, but efforts to further improve guideline adherence must be targeted toward patient groups who receive the worse treatment at discharge, e.g. NSTEMI patients and only medical treatment sub-group.