TABLE 2.
Adherence to the criteria of MATNSTEACS (n = 228).
| No | Criteria a | Applicability | % Adjusted adherence (95%CI) |
|---|---|---|---|
| Antithrombotic therapy | |||
| 1 | Patient with no contraindication to aspirin is prescribed a daily dose of aspirin 81–325 mg, indefinitely | 228 | 95.6 (91.8–97.8) |
| 2 | Patient who is not prescribed aspirin due to hypersensitivity is prescribed clopidogrel 75 mg daily | 6 | 100 (51.7–98.5) |
| 3 | Patient treated with the ischemic-guided strategy, in addition to aspirin 81 mg (if not contraindicated), is prescribed clopidogrel 75 mg OD or ticagrelor 90 mg BID for a duration of up to 12 months | 46 | 54.3 (39.2–68.8) |
| 4 | Patient with stent post primary PCI is prescribed clopidogrel 75 mg or ticagrelor 90 mg BID daily for at least 12 months, in addition to aspirin 81 mg as a dual therapy | 163 | 86.5 (80.1–91.2) |
| 5 | Patient on dual antiplatelet therapy and at higher than average risk of gastrointestinal bleeding is prescribed a proton pump inhibitor | 40 | 90.0 (75.4–96.8) |
| Beta-blockers | |||
| 6 | Patient with an LVEF ≤ 40% with no contraindications to beta-blockers and prescribed a beta-blocker is prescribed either metoprolol succinate SR, bisoprolol, or carvedilol | 38 | 92.1 (77.5–97.9) |
| Lipid-lowering therapies | |||
| 7 | Patient regardless of lipid levels is prescribed a high intensity statin either atorvastatin 40–80 mg or rosuvastatin 20–40 mg | 228 | 61.0 (54.3–67.3) |
| 8 | Patient with an LDL ≥ 1.8 mmol/L and despite a maximally tolerated statin should be on further therapy (ezetimibe) | 92 | 13.0 (7.2–22.1) |
| Inhibitors of renin–angiotensin–aldosterone system | |||
| 9 | Patient with a confirmed LVEF ≤ 40% or heart failure, or hypertension or diabetes is prescribed an ACE inhibitor | 199 | 89.5 (84.1–93.2) |
| 10 | Patient with intolerance to ACE inhibitors with a confirmed LVEF ≤ 40% or heart failure, or hypertension or diabetes is prescribed ARB | 28 | 100 (85.0–99.7) |
| 11 | Patient already receiving an ACEI and beta-blocker and have LVEF ≤ 40%, and either heart failure or diabetes (without significant renal dysfunction, or hyperkalemia) is prescribed an aldosterone antagonist | 37 | 29.7 (16.4–47.2) |
a
Criteria were developed and validated from the ESC guidelines (Roffi et al., 2016; Ibanez et al., 2018) and the ACC/AHA guidelines (Amsterdam et al., 2014; O'Gara et al., 2013).