Adverse drug events in patients treated with cardiovascular drugs and anticoa gulants

Objective: To evaluate the incidence of serious adverse drug events (ADE's) caused by cardiovascular drugs, identify patients at highest risk and characterize unique Israeli factors. Design: A prospective study. Setting: 48 beds department of internal medicine. Patients and Methods: All patients admitted from November 1999 to January 2000 were monitored, those treated with cardiovascular drugs and/or anticoagulants were included. Naranjo algorithm was used to yield the probability of serious ADE's. Results: Of 496 patients reviewed 20(4%) had serious ADE's. Comparing the ADE's group to control group: patients were older (72±12.6 years Vs 65±13 years p=0.048) hospital stay was prolonged (7.3±5.5 days Vs 5.2±3.7 days p=0.018) urea levels were higher (65±56 mg/dL Vs 47±32 mg/dL P=0.027) and drug allergy was found in 10(50%). Hypertension and atrial fibrillation were found in 18(90%) and 9(45%) patients respectively. Drugs involved were: warfarin 25%, beta-blockers 15%, combination of Ca++ channel blockers, nitrates, diuretics, and ACE inhibitors 50%. Conclusions: 4% of patients taking cardiovascular drugs developed serious ADE's. Patients at risk were older, on multiple drugs, with higher urea levels. Atrial fibrillation and hypertension were the most common pathologies. Accordingly warfarin and beta blockers were the leading drugs. Although Israel is an immigration country no special Israeli characteristics were found.