BACKGROUND: Only limited data are available for the recent trend of optimal evidence-based medical therapy at discharge after acute myocardial infarction (AMI) in Asia. We evaluated the predictors for the use of optimal evidence-based medical therapy at discharge and the association between discharge medications and 6-month mortality after AMI. METHODS: Between November 2005 and January 2008, we evaluated the discharge medications among 9,294 post-MI survivors who did not have any documented contraindications to antiplatelet drugs, beta-blockers, angiotensin-converting enzyme inhibitors (ACE-Is)/angiotensin II receptor blockers (ARBs), or statins in the Korea Acute Myocardial Infarction Registry. Optimal evidence-based medical therapy was defined as the use of all 4 indicated medications. RESULTS: Of these patients, 4,684 (50.4%) received all 4 medications at discharge. The discharge prescription rates of antiplatelet drugs, beta-blockers, ACE-Is/ARBs, and statins were 99.0%, 72.7%, 81.5%, and 77.2%, respectively. In multivariate analysis, advanced age, lower systolic blood pressure, higher Killip class at admission, left ventricular systolic dysfunction, higher blood creatinine level, lower total cholesterol levels, and coronary artery bypass grafting during hospitalization were independently associated with less use of optimal evidence-based medical therapy. In contrast, patients who underwent percutaneous coronary intervention were more likely to use optimal medications. In Cox proportional hazards model, optimal evidence-based medical therapy was an independent predictor of 6-month mortality after adjusting clinical characteristics and angiographic and procedural data. CONCLUSIONS: The optimal evidence-based medical therapy is prescribed at suboptimal rates, particularly in patients with high-risk features. New educational strategies are needed to increase the use of these secondary preventive medical therapies. Copyright 2010 Mosby, Inc. All rights reserved.
RCT Entities:
BACKGROUND: Only limited data are available for the recent trend of optimal evidence-based medical therapy at discharge after acute myocardial infarction (AMI) in Asia. We evaluated the predictors for the use of optimal evidence-based medical therapy at discharge and the association between discharge medications and 6-month mortality after AMI. METHODS: Between November 2005 and January 2008, we evaluated the discharge medications among 9,294 post-MI survivors who did not have any documented contraindications to antiplatelet drugs, beta-blockers, angiotensin-converting enzyme inhibitors (ACE-Is)/angiotensin II receptor blockers (ARBs), or statins in the Korea Acute Myocardial Infarction Registry. Optimal evidence-based medical therapy was defined as the use of all 4 indicated medications. RESULTS: Of these patients, 4,684 (50.4%) received all 4 medications at discharge. The discharge prescription rates of antiplatelet drugs, beta-blockers, ACE-Is/ARBs, and statins were 99.0%, 72.7%, 81.5%, and 77.2%, respectively. In multivariate analysis, advanced age, lower systolic blood pressure, higher Killip class at admission, left ventricular systolic dysfunction, higher blood creatinine level, lower total cholesterol levels, and coronary artery bypass grafting during hospitalization were independently associated with less use of optimal evidence-based medical therapy. In contrast, patients who underwent percutaneous coronary intervention were more likely to use optimal medications. In Cox proportional hazards model, optimal evidence-based medical therapy was an independent predictor of 6-month mortality after adjusting clinical characteristics and angiographic and procedural data. CONCLUSIONS: The optimal evidence-based medical therapy is prescribed at suboptimal rates, particularly in patients with high-risk features. New educational strategies are needed to increase the use of these secondary preventive medical therapies. Copyright 2010 Mosby, Inc. All rights reserved.
Authors: T Yetgin; M M J M van der Linden; A G de Vries; P C Smits; R van Mechelen; S C Yap; E Boersma; F Zijlstra; R-J M van Geuns Journal: Neth Heart J Date: 2014-01 Impact factor: 2.380
Authors: Hyun Kuk Kim; Myung Ho Jeong; Seung Hun Lee; Doo Sun Sim; Young Joon Hong; Youngkeun Ahn; Chong Jin Kim; Myeong Chan Cho; Young Jo Kim Journal: Korean J Intern Med Date: 2014-10-31 Impact factor: 2.884
Authors: Ursula Kirchmayer; Mirko Di Martino; Nera Agabiti; Lisa Bauleo; Danilo Fusco; Valeria Belleudi; Massimo Arcà; Luigi Pinnarelli; Carlo Alberto Perucci; Marina Davoli Journal: Pharmacoepidemiol Drug Saf Date: 2013-06 Impact factor: 2.890
Authors: Laercio Martins De Stefano; Alex Lombardi Barbosa Ferraz; Ana Lúcia dos Anjos Ferreira; Ana Lúcia Gut; Ana Lúcia Cogni; Elaine Farah; Beatriz Bojikian Matsubara Journal: PLoS One Date: 2013-10-22 Impact factor: 3.240