Adherence of cardiologists to ACC/AHA guideline in the treatment of patients with unstable angina

Concerns about the known consequences of non adherence to standard treatment protocols by physicians in patients suffering from ACS and the lack of any dependable statistics as regards the degree of adherence in Iran and also the existence of different statistics on the subject in different countries led the present researchers to conduct an investigation to determine the extent of adherence to ACC/ AHA guidelines among cardiologists in patients with ACS. A cross sectional study was done in Shahid Modarres hospital in 2010. All patients suspected with ACS were investigated and those with definite diagnosis during angiography were included in the research. Their treatment protocols were investigated and the level of adherence to AHA guidelines was determined such that a ≥75% conformity with the guidelines was classified as complete adherence; 50% to 75% as relative adherence and <50% was classified as non adherence. K2 test was used in the analysis of data. Eighty-five patients with definite diagnosis of ACS were chosen out of 100 suspected patients. Complete adherence to the AHA protocol was noted in 47.1%, relative adherence in 32.9% and non adherence in 20%. In other words the level of adherence was unacceptable in 52.9%. No elements of individual characteristics and risk factors had any effect on the level of adherence (p<0.7). The high level of non adherence of the ACC/AHA guidelines in treatment of patients suffering from ACS is a cause of great concern. It is strongly recommended that a scientific investigation be carried out as the cause of this non adherence on the part of the cardiologists along with an investigation into the outcome of these patients.