Is prophylactic treatment after myocardial infarction evidence-based?
OBJECTIVE
We aimed to evaluate the use of evidence-based prophylactic treatment after myocardial infarction on hospital discharge and in primary care after 1 year of hospitalization.


RESULTS
We conducted a 1-year prospective study of all the patients discharged from a tertiary hospital who had been treated for myocardial infarction from January 1 to December 31 1995. Three hundred and eighty surviving patients were consecutively discharged from the hospital. Seventy per cent of patients were treated with aspirin, 45% with beta-blockers, 27% with calcium channel blockers, 26% with ACE inhibitors, 40% with nitrates and 8% with cholesterol-lowering drugs after discharge from the hospital. In primary care, prescription of lipid-lowering drugs increased to 17%, while prescription of beta-blockers decreased to 34%. ACE inhibitor prescriptions at discharge were clearly more common in patients with impaired ventricular function or heart failure (57%).


CONCLUSIONS
According to the evidence, there is still potential for reducing the risk of a further ischaemic event or death in patients with MI, especially by increasing the use of beta-blockers and lipid-lowering drugs.
Brotons
C
C
Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Calvo
F
F
Cascant
P
P
Ribera
A
A
Moral
I
I
Permanyer-Miralda
G
G
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000517:prevention & control*; D005996:Nitroglycerin / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D013030:Spain; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D005996:Nitroglycerin; D001241:Aspirin