Aldosterone Antagonists in ST Elevation Myocardial Infarction Patients with Low Left Ventricular Ejection Fraction: a Retrospective Study at Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal.

Background: Aldosterone antagonists (AA) improve survival in ST elevation myocardial infarction (STEMI) patients with left ventricular ejection fraction(LVEF) "T40% ,with either clinical heart failure or diabetes mellitus. Our aim was to assess the adherence of AA use in Shahid Gangalal National Heart Centre, Kathmandu, Nepal.

Methods: Medical records of 171 STEMI patients with LVEF "T40% and discharged from our centre between January 2012 and December 2012 were retrospectively reviewed, regarding the use of AA use.

Results: Among the 171 STEMI patients with LVEF "T40%, 5 patients were excluded study due to the presence of contraindication to AA therapy. Among the remaining 166 patients, only 135 (81.2%) patients were eligible for the AA therapy (58 patients with diabetes mellitus and clinical heart failure in 77 patients). Out of 58 diabetes mellitus patients, 28 (48.2%) patients were treated with AA. Whereas 39(50.6%) out of 77 patients with clinical heart failure were treated with AA. Overall, 67(49.6%) patients among 135 eligible patients were treated with AA.

Conclusions: As in the international studies AA is under-used in our patient population. We still need some more effort to improve our prescription rate.