[Treatment of myocardial infarction: from the reading of publishing work to everyday prescription].
Many therapeutic trials have demonstrated an improvement in the prognosis of myocardial infarction. The practitioner, before changing his prescribing habits, should pose questions to which the authors propose answers. The prescriber should check that the new treatment has been adequately validated by verifying the quality of the therapeutic studies (classical, mega trials such as ISIS or GISSI, metaanalysis). He should also check that a trial population is representative of his own patients (ethnic and social factors, high percentages of patients actually included in the trial compared with those eligible for inclusion). He should insure that his own conditions of practice (patient follow-up, delays and quality of specialised intervention) would provide the same benefit-risk ratio as in the clinical trial. Finally, by analysing patients subgroups or even better, factorial subgroups, and above all, the mode of action of the drugs, he should check that the new treatment may be associated with already established therapeutic modalities. In conclusion, nothing can replace case by case clinical judgment in the application of the results of the literature to everyday practice.
Weber
S
S
Service de cardiologie, hôpital Cochin, Paris.
D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011643:Publishing / Q000706:statistics & numerical data
Traitement de l'infarctus myocardique: de la lecture des publications à la prescription quotidienne...