Cardiovascular disease is the leading cause of death in Australia, accounting for the largest portion of recurrent health expenditures. The benefits of antiplatelet drugs is well-established, with aspirin being recommended for primary and secondary prevention of cardiovascular events. Systematic reviews show that the benefits of antiplatelet drugs largely outweigh the risk of major bleeding. The objective of this audit was to assess the cardiovascular risk in all medical inpatients, identify patients with high risk of cardiovascular disease, and document the usage of antiplatelet drugs among these patients at Repatriation General Hospital in South Australia. This was a cross-sectional retrospective study that recorded antiplatelet drug use for all medical inpatients on a specified audit day. Non-medical unit patients were excluded. Cardiovascular risk was assessed by using the New Zealand cardiovascular risk and the Australian absolute cardiovascular disease risk calculators. Data regarding antiplatelet drug use and cardiovascular risk was obtained from case note reviews and computer pathology results. The results of this audit indicate that the majority of patients in the inpatient medical units are at high risk of cardiovascular disease based on the New Zealand cardiovascular risk and the Australian absolute cardiovascular disease risk calculators. For those using antiplatelet drugs, most patients are in the high risk group, but not all of them are on antiplatelet drugs. Prescribing antiplatelets for patients with high cardiovascular risk was not addressed as diligently in changes in management strategies. The majority of the patients are at high risk of developing cardiovascular disease due solely to reason of age. Only half of them are on antiplatelet therapy. This audit also identified a need to consider the assessment of cardiovascular disease risk among all patients admitted in the medical unit.
ASSESSMENT OF HIGH CARDIOVASCULAR DISEASE RISK PATIENTS AND THE APPROPRIATE USE OF ANTIPLATELET DRUGS