Trends in myocardial infarction treatment in subjects aged 35-64 in Southwestern France, 1986-93.
BACKGROUND
The Southwestern region of France is characterized by a low mortality rate from MI. Since screening and management of the main cardiovascular risk factors has remained stable in this region, we hypothesized that any decrease in CHD mortality would be due to a better treatment of MI cases.


METHODS
Analysis of all MI treatments during hospitalization and at discharge collected between 1986 and 1993 in the Toulouse-MONICA register.


RESULTS
During the acute phase and at discharge from hospital, the prescription of beta-blockers and antiplatelet drugs increased whereas the prescription of calcium channel blockers decreased in men and women, although in women most trends did not reach statistical significance. In men, angioplasty increased steadily, whereas thrombolysis showed an increase followed by a slight decrease after 1991. After multivariate analysis adjusting for age, year, blood pressure, smoking status and personal history of coronary heart disease, women received significantly less beta-blockers and angioplasty and more calcium channel blockers and diuretics than men, while no differences were found for thrombolysis.


CONCLUSIONS
The prescription of the most efficient therapies against MI has increased in Southwestern France during the period studied. The reasons for a lower prescription of beta-blockers and angioplasty in women remain to be assessed.
Marques-Vidal
Pedro
P
INSERM U558, Faculté de Médecine Purpan, Allées Jules Guesde, Toulouse, France.
Ruidavets
Jean-Bernard
JB
Cambou
Jean-Pierre
JP
Ferrières
Jean
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D017130:Angioplasty / Q000639:trends; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000639:trends*; D055656:Prescriptions / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000639:trends; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D010975:Platelet Aggregation Inhibitors