Complementary/Alternative Medicine

Use of complementary and alternative medicine is common among persons who have been hospitalized for coronary artery disease

Nearly one-fifth of patients hospitalized for acute coronary syndrome (ACS, heart attack or unstable angina) were using complementary and alternative medicine (CAM) at the time of hospital admission. However, patients did not use CAM therapies at the expense of traditional evidence-based therapies. Rather, it was quite the opposite, according to a new study: CAM users were just as likely as non-CAM users to use aspirin (73 vs. 74 percent) or statins (71 vs. 68 percent), and were significantly more likely to use beta blockers (64 vs. 46 percent). Adjusting for demographic, socioeconomic factors, medical history, and coexisting illnesses did not change the results.

More CAM users than non-CAM users were uninsured (12 vs. 7 percent), economically burdened (58 vs. 29 percent), and had a history of depression (13 vs. 6 percent)—all typically associated with poorer medication compliance, note the researchers. Their findings suggest that patients with coronary artery disease (CAD) are using CAM as an adjunctive therapy rather than replacement for conventional treatments.

CAM users were more likely to arrive at the hospital with unstable angina than heart attack and to have a history of depression and high blood pressure. Also, more CAM users were white (31 vs. 12 percent) than other races. The most frequently reported CAM therapies were use of formal relaxation techniques and home remedies. The impact of CAM on such outcomes as mortality and health status in patients with CAD is unknown. Nevertheless, without evidence of harm, the findings suggest no reason to discourage CAM use in patients with CAD, conclude the researchers.

Their study was based on analysis of a registry of patients hospitalized with ACS at two Missouri hospitals in 2001 and 2002 and patients' self-reported use of CAM and evidence-based therapies. The study was supported by the Agency for Healthcare Research and Quality (HS11282).

More details are in "Self-reported use of complementary and alternative medicine in patients with previous acute coronary syndrome," by Carole Decker, R.N., Ph.D., Jason Huddleston, D.O., Mikhail Kosiborod, M.D., and others, in the April 2007 American Journal of Cardiology 99, pp. 930-933.

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