title: Long-term compliance with beta-blockers, angiotensin-converting enzyme inhibitors, and statins after acute myocardial infarction.
abstract: OBJECTIVE
  To study initiation, dosages, and compliance with beta-blockers, angiotensin-converting enzyme (ACE)-inhibitors, and statins in patients after acute myocardial infarction (AMI) and to identify likely targets for improvement.
  
  
  RESULTS
  Patients admitted with first AMI between 1995 and 2002 were identified by linking nationwide administrative registers. A total of 55 315 patients survived 30 days after discharge and were included; 58.3% received beta-blockers, 29.1% ACE-inhibitors, and 33.5% statins. After 1, 3, and 5 years, 78, 64, and 58% of survivors who had started therapy were still receiving beta-blockers, 86, 78, and 74% were receiving ACE-inhibitors, and 85, 80, and 82% were receiving statins, respectively. Increased age and female sex were associated with improved compliance. The dosages prescribed were generally 50% or less of the dosages used in clinical trials, and dosages did not increase during the observation period. Patients who did not start treatment shortly after discharge had a low probability of starting treatment later.
  
  
  CONCLUSIONS
  The main problem with underuse of recommended treatment after AMI is that treatment is not initiated at an appropriate dosage shortly after AMI. A focused effort in the immediate post-infarction period would appear to provide long-term benefit.
authors.affiliation: Department of Cardiovascular Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. gg@heart.dk
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.forename: Jeppe N
authors.initials: JN
authors.lastname: Rasmussen
authors.forename: Steen Z
authors.initials: SZ
authors.lastname: Abildstrøm
authors.forename: Niels
authors.initials: N
authors.lastname: Gadsbøll
authors.forename: Pernille
authors.initials: P
authors.lastname: Buch
authors.forename: Jens
authors.initials: J
authors.lastname: Friberg
authors.forename: Søren
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Steen
authors.initials: S
authors.lastname: Stender
authors.forename: Mette
authors.initials: M
authors.lastname: Madsen
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003718:Denmark; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D010349:Patient Compliance; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors