The evaluation of short and long-term administration of drugs improving life expectancy in patients with myocardial infarction in a Hungarian county hospital.
OBJECTIVE
The patients after myocardial infarction could hope for a significant improvement in their life expectancy when complying with the principles of the secondary prevention. Today there is no doubt that the administration of ACE-inhibitors, beta-blockers, aspirin and statins decrease mortality in these patients. Although the clinicians are aware of the guidelines of Evidence Based Medicine, international and Hungarian surveys show that in their everyday application there is still much to improve.


METHODS
The authors studied the therapy of 200 consecutive patients (115 men and 85 women) who suffered from acute myocardial infarction (either STAMI or NSTAMI) in 1999-2000 at the discharge from their internal medicine department with cardiological profile and 6 months later during outpatient check-up. Having these therapeutic data a special emphasise was given to the same group of drugs and their administration was investigated in patients suffering from acute coronary syndrome with elevated troponin-T levels in the year 2002.


RESULTS
In the study of years 1999-2000 at the discharge 175 of 200 patients received ACE-inhibitor (87%), 121 (60%) beta-blocker, 180 (90%) antiplatelet and 102 (51%) statin therapy. At the time of the control performed 6 months later 85% of the patients were on ACE-inhibitor, 88% on beta-blocker, 77% on aspirin and 47% on statin therapy. In this high risk population during the 6 months control the LDL-cholesterol goal of 2.5 mmol/l was attained in the 17% of patients. In the survey performed in 2002 the use of beta-receptor blocker increased to 85%, antiplatelet drug and statin administration to 95% and 57%, respectively.


CONCLUSIONS
Although the administration of drugs improving life expectancy in the authors' department is comparable with the published Hungarian and international data, effort to the widespread application of the ever growing principles of the Evidence Based Medicine and continuous self-control are essential.
Márk
László
L
Department of Internal Medicine II - Cardiology, Pándy Kálmán Békés County Hospital, Gyula, Hungary. mark@pandy.hu
Dani
Gyozo
G
Nagy
Erzsébet
E
Erdei
Ferenc
F
Katona
András
A
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006766:Hospitals, County; D006801:Humans; D006814:Hungary; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D008017:Life Expectancy; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors