Does the pharmacological management of unstable angina vary with age and gender - A descriptive study

Purpose: Observational registries have shown the underutilization of evidence based therapies in women and elderly patients. While the burden of unstable angina is high in India, there is minimal data on the drug utilization patterns. Also, gender and age differences in the treatment have not been assessed. This study intends to present the data on drug utilization in the management of unstable angina in a tertiary care hospital and to detect the presence of significant gender or age related differences in the treatment. Method: The case record files of all patients who were admitted with unstable angina during January 2006 to December 2008 were studied. The demographical details, comorbidities, the duration of the hospital stay, outcomes and the drugsadministered within 24 hours of admission and at discharge for each case was obtained. Results: Of the 318 patients, 63.2% were males and 55.7% were less than 65 years of age. The mean (± SD) age of the males was 60.64 (± 11.71) years as compared to the mean age of 64.21 (± 9.98) years in females (p=0.006). The overall mortality was 1.89%. There was an underutilization of aspirin and betablockers in the elderly, while antiplatelet agents and anigotensin converting enzyme inhibitors were used to a lesser extent in females. The prescription rate of statins was high. Conclusion: There was an underutilization of drugs in the elderly and in female patients. The results are similar to the data reported from previous studies. The diagnosis and management of unstable angina poses a difficult challenge because these subgroups quite often present with atypical symptoms and have less extensive coronary artery disease.