[Utilization of thrombolytic drugs in Barcelona. Study Group on Secondary Prevention of Myocardial Infarction].
BACKGROUND
A number of clinical trials including more than 50,000 patients have shown the efficacy of thrombolytic therapy in reducing mortality associated with acute myocardial infarction (AMI). However, the results of some recently published drug utilization studies have shown that only one third of admitted patients with a diagnosis of AMI receive thrombolytic treatment. The aim of the present study was to quantify and characterize the use of thrombolytic drugs in three hospitals in Barcelona, Spain.


METHODS
We collected retrospective information about some clinical variables and drug prescription of patients discharged with a diagnosis of AMI from three hospitals in Barcelona between January and June 1994.


RESULTS
Three hundred and sixty-four patients (247 men, 68%) with a mean age of 68 years (SD 13) were included in the study. The median time from the beginning of clinical symptoms to hospital admission was 3 h (range 1 to 96). One hundred and two patients (28%) were prescribed thrombolytic drugs, and of these, 62%, received streptokinase. No one patient received any thrombolytic treatment before hospital admission. In a multivariate analysis the following variables were negatively associated with thrombolytic use: age over 75 years, more than three hours from the beginning of symptoms to hospital admission and an EKG with bundle-branch block, ST depression or normal. After excluding patients with limitations to thrombolytic use, 18% of all patients could be identified who did not receive any thrombolytic treatment they could have benefited from.


CONCLUSIONS
Only one third of admitted patients with a diagnosis of AMI in the three study hospitals receive thrombolytic treatment. One fifth of the study population with AMI does not receive any thrombolytic therapy but could have benefited from it.
Agustí
A
A
Servicio de Farmacología Clínica, Ciutat Sanitària i Universitària Vall d'Hebron, Barcelona.
Mateu
S
S
Molina
L
L
Arnau
J M
JM
Vidal
X
X
Laporte
J R
JR
D000367:Age Factors; D000368:Aged; D004363:Drug Utilization; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D012189:Retrospective Studies; D013030:Spain
D005343:Fibrinolytic Agents
Utilización de fármacos trombolíticos en Barcelona. Grupo de Estudio para la Prevención Secundaria del Infarto de Miocardio.