Frequency of sublingual nitroglycerin prescription in patients with coronary artery disease and angina and awareness of patients about the shelf life of the drug [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(6): 469-473 | DOI: 10.5543/tkda.2011.01635

Frequency of sublingual nitroglycerin prescription in patients with coronary artery disease and angina and awareness of patients about the shelf life of the drug

Ömer Çağlar Yılmaz1, Gökhan Keskin Keskin2, Bilal Çuğlan3, Yusuf Selçoki1, Ayla Temizkan1, Beyhan Eryonucu1, Özlem Soran4
1University of Fatih, Department of Cardiology, Ankara, Turkey
2Türkiye Yüksek İhtisas Training And Research Hospital, Department of Cardiology, Ankara, Turkey
3Inonu University, Faculty of Medicine, Department of Cardiology, Malatya, Turkey
4University of Pittsburgh, Department of Cardiology, Pittsburgh, Pa, Usa


OBJECTIVES
ACC/AHA/ESC guidelines recommend sublingual nitroglycerin (SNG) in patients with stable angina pectoris and coronary artery disease (CAD). However, the shelf life of SNG following first use is six months for SNG tablets and two years for SNG sprays. We investigated the frequency of prescription of SNG tablets/sprays in patients having anginal symptoms and documented CAD and the awareness levels of patients about appropriate use of SNG.

STUDY DESIGN
Three hundred patients (201 men, 99 women; mean age 61.7±10.8 years) with documented CAD and angina were enrolled into this study. Angina pectoris was categorized according to the functional classification system of the Canadian Cardiovascular Society. Data on cardiovascular past histories, risk factors, medications, and the use of SNG were recorded.

RESULTS
At least one risk factor was present in 96% of the patients. Only 46% of the patients had a prescription for SNG. Of those with a prescription of SNG tablet and spray, 91.8% and 84.4% did not know the shelf life of the product, respectively. Of those who were routinely carrying SNG, 35.6% had an expired product. Of those with a prescription of SNG, only 65.9% were informed by the physician on the proper use of SNG.

CONCLUSION
Our results show that, despite recommendations of the guidelines, SNG is not prescribed to a substantial percentage of patients with CAD and angina, a considerable fraction of patients carry an expired product, and that patients are not adequately informed by the physicians on the use of SNG. These problems will certainly affect the optimal medical management of CAD and its efficacy.

Keywords: Angina pectoris/drug therapy, coronary artery disease, nitroglycerin/therapeutic use, practice guidelines as topic; vasodilator agents

How to cite this article
Ömer Çağlar Yılmaz, Gökhan Keskin Keskin, Bilal Çuğlan, Yusuf Selçoki, Ayla Temizkan, Beyhan Eryonucu, Özlem Soran. Frequency of sublingual nitroglycerin prescription in patients with coronary artery disease and angina and awareness of patients about the shelf life of the drug. Turk Kardiyol Dern Ars. 2011; 39(6): 469-473

Corresponding Author: Özlem Soran, United States
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