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

BACKGROUND: The aim of the study was to investigate the adherence to ESC guidelines in patients discharged after ACS in Georgia. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.