Drug utilization Evaluation of anticoagulants in patients with cardiovascular disease and COVID-19 in Shahid Madani Hospital Tabriz

Abstract

Introduction: Anticoagulant drugs, such as heparin and enoxaparin, have been used for various indications, particularly for the prevention of thromboembolic events during the COVID-19 pandemic. We conducted a study to examine the administration patterns of these drugs and compare them with established guidelines, aiming to prevent inappropriate use and improve patient treatment.Objective: To evaluate the consumption patterns of anticoagulant drugs in cardiovascular patients with COVID-19 at Shaheed Madani Heart Hospital in Tabriz.

Material and Methods:This retrospective cross-sectional study was conducted on cardiovascular patients with COVID-19 who were hospitalized at Shahid Madani Hospital in 2021. The study examined patients who received anticoagulant medications, including heparin, enoxaparin, or oral anticoagulants, over a 6-month period. Patient information, including age, gender, medication history, medical and allergy history, history of substance abuse (alcohol, smoking, and drugs), length of hospitalization, dosage, indications, and duration of anticoagulant therapy, were reviewed and compared with established guidelines. The recommended dosage for heparin was set at 5000 units every twelve hours, and for enoxaparin, it was 40 mg subcutaneously once daily.

Results:Heparin use was deemed rational in 59.87% of patients, and enoxaparin use was rational in 55.19% of patients. Additionally, it was found that there was no significant association between the rational prescription of anticoagulant drugs and final patient outcomes. However, mortality was significantly associated with diabetes mellitus (P=0.047, r=0.163) and chronic kidney disease (P=0.045, r=0.164).Conclusion:The present study found that the rational use of heparin and enoxaparin is acceptable. No significant association was found between the rational prescription of these drugs and the examined factors. However, the presence of chronic kidney disease and diabetes mellitus was associated with higher mortality rates.