Changes over time in the use of aspirin in patients hospitalized with acute myocardial infarction (1975 to 1997): a population-based perspective.
OBJECTIVE
The purpose of this study was to examine 2 decade-long trends in the use of aspirin and associated outcomes in patients hospitalized with acute myocardial infarction.


BACKGROUND
Aspirin has been shown to be beneficial in the secondary prevention of AMI. However, little is known about changes over time in the use of aspirin in patients hospitalized with AMI and associated outcomes, particularly from a more generalizable population-based perspective.


METHODS
We examined trends in aspirin use and hospital and long-term outcomes in 9336 metropolitan Worcester, Mass, residents hospitalized with validated AMI in all area hospitals between 1975 and 1997.


RESULTS
Between 1975 and 1986, the hospital use of aspirin remained stable at approximately 20%. Use of aspirin increased markedly after this time from 49% in 1988 to 91% in 1997. Younger age, male sex, and a history of hypertension or stroke were associated with an increased likelihood of receiving aspirin. Patients with diabetes were less likely to receive aspirin than were patients without diabetes. Patients who received aspirin during hospitalization were more likely to receive beta-blockers and coronary interventions. Patients treated with aspirin were significantly less likely to have heart failure or cardiogenic shock develop or to die during hospitalization as compared with patients not treated with aspirin. Patients treated with aspirin had significantly higher survival rates over a 10-year follow-up period.


CONCLUSIONS
The results of this community-wide study show that aspirin use in patients hospitalized with AMI has dramatically increased over time. Despite the beneficial effects associated with the use of aspirin, this therapy remains underused in several high-risk groups.
Jackson
Elizabeth A
EA
Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Mass 01655, USA. elizabeth.jackson@umassmed.edu
Sivasubramian
Ramya
R
Spencer
Frederick A
FA
Yarzebski
Jorge
J
Lessard
Darleen
D
Gore
Joel M
JM
Goldberg
Robert J
RJ
D017677:Age Distribution; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology*; D011159:Population Surveillance; D011446:Prospective Studies; D017678:Sex Distribution; D015996:Survival Rate
D001241:Aspirin