New Role of Cardiology Pharmacist For ST Elevation NST Elevation Myocardial Infarction Patients In King Narai Hospital, Lopburi province.

Abstract

      A prospective study was conducted among all STEMI and NSTEMI inpatients admitted to Phra Narai Maharaj Hospital from January 2022 to June 2024. Clinical pharmacists took a proactive role in multidisciplinary care by monitoring pharmacotherapy, providing QR codes for drug information, monitoring adverse drug events (ADVs), conducting discharge counseling, and coordinating with Village Health Volunteers (VHVs) to ensure medication adherence. Fibrinolytic protocols for STEMI patients were upgraded from Streptokinase to Alteplase in 2022 and to Tenecteplase in 2024. Data were analyzed using descriptive statistics and logistic regression.

      Results: STEMI Group (n = 286): 93.71% received novel pharmacist interventions. Of the 247 patients receiving fibrinolytic therapy, 12.59% experienced adverse events (most common: minor bleeding at 4.20% and hypotension at 3.50%). NSTEMI Group (n = 534): 83.71% received novel pharmacist interventions. A total of 198 DRPs were identified, primarily failure to receive medication (27.30%) and untreated indications (24.20%). Physicians accepted 88.40% of the pharmacists' recommendations. Mortality Rates: Treatment with Aspirin, Clopidogrel, Enoxaparin, and Statins, alongside smoking history, significantly reduced mortality ($p < 0.05$). The overall mortality rate dropped to 9.42% in STEMI patients and 7.41% in NSTEMI patients, successfully achieving the target (< 9–10%).