P Tuppin1, A Neumann, D Simon, A Weill, C de Peretti, N Danchin, P Ricordeau, H Allemand. 1. Direction de la stratégie des études et des statistiques (DSES), département des études sur les pathologies et les patients (DEPP), Caisse nationale d'assurance maladie des travailleurs salariés, 75986 Paris cedex 20, France. philippe.tuppin@cnamts.fr
Abstract
AIM: The objective of this study was to compare the management of diabetic and non-diabetic patients before, during and after hospitalization for myocardial infarction (MI). METHODS: Hospital admissions for MI in France from January to June 2006 were obtained from the national hospital-discharge database and merged with data on medications, 6 months before and after hospitalization of patients covered by the general health insurance scheme. Diabetic patients were identified by having at least two refunds for antidiabetic medications 6 months before the index hospitalization. Results comparing diabetic and non-diabetic patients were adjusted for age and gender. RESULTS: Of the 14,007 patients included in the study, 2545 were diabetic (18.2%). Before hospital admission, diabetic patients more frequently received secondary cardiovascular preventative medications (12.7% vs 4.2%; P<0.0001) and stent implants (4.2% vs 2.2%; P<0.0001) than did non-diabetic patients. During hospitalization and the following month, angioplasty (56.1% vs 61.7%; P=0.0001) and stent implantation (53.3% vs 59.3%; P<0.0001) were less frequently performed in diabetic patients and only coronary angiography was done in similar proportions of diabetic and non-diabetic patients (16.7% vs 15.2%). In addition, during the 6 months after hospitalization, diabetic vs non-diabetic patients had more admissions for cardiovascular reasons (36.9% vs 29.5%; P<0.0001) and were prescribed more secondary preventative medications (65.9% vs 61.7%; P<0.0001). They were also more frequently treated with insulin only (19.6% 6 months before vs 27.2% 6 months after) or oral antidiabetic drugs (14.6% vs 19.7%, respectively) than were non-diabetics. CONCLUSION: French diabetic patients subsequent to MI undergo fewer angioplasty procedures than do non-diabetic patients. After the acute stage, secondary preventative medications are used more often, with a marked rise in the use of insulin. (c) 2010 Elsevier Masson SAS. All rights reserved.
AIM: The objective of this study was to compare the management of diabetic and non-diabeticpatients before, during and after hospitalization for myocardial infarction (MI). METHODS: Hospital admissions for MI in France from January to June 2006 were obtained from the national hospital-discharge database and merged with data on medications, 6 months before and after hospitalization of patients covered by the general health insurance scheme. Diabeticpatients were identified by having at least two refunds for antidiabetic medications 6 months before the index hospitalization. Results comparing diabetic and non-diabeticpatients were adjusted for age and gender. RESULTS: Of the 14,007 patients included in the study, 2545 were diabetic (18.2%). Before hospital admission, diabeticpatients more frequently received secondary cardiovascular preventative medications (12.7% vs 4.2%; P<0.0001) and stent implants (4.2% vs 2.2%; P<0.0001) than did non-diabeticpatients. During hospitalization and the following month, angioplasty (56.1% vs 61.7%; P=0.0001) and stent implantation (53.3% vs 59.3%; P<0.0001) were less frequently performed in diabeticpatients and only coronary angiography was done in similar proportions of diabetic and non-diabeticpatients (16.7% vs 15.2%). In addition, during the 6 months after hospitalization, diabetic vs non-diabeticpatients had more admissions for cardiovascular reasons (36.9% vs 29.5%; P<0.0001) and were prescribed more secondary preventative medications (65.9% vs 61.7%; P<0.0001). They were also more frequently treated with insulin only (19.6% 6 months before vs 27.2% 6 months after) or oral antidiabetic drugs (14.6% vs 19.7%, respectively) than were non-diabetics. CONCLUSION: French diabeticpatients subsequent to MI undergo fewer angioplasty procedures than do non-diabeticpatients. After the acute stage, secondary preventative medications are used more often, with a marked rise in the use of insulin. (c) 2010 Elsevier Masson SAS. All rights reserved.
Authors: Anke Neumann; Géric Maura; Alain Weill; Philippe Ricordeau; François Alla; Hubert Allemand Journal: Pharmacoepidemiol Drug Saf Date: 2013-12-02 Impact factor: 2.890