Contemporary diagnosis and management of hypercholesterolemia in elderly acute myocardial infarction patients: a population-based study.
There are limited data regarding the diagnosis and treatment of hypercholesterolemia in elderly patients with acute myocardial infarction (AMI). The authors describe the in-hospital and discharge prescription patterns of lipid-lowering agents in patients hospitalized with an AMI, and identify factors associated with low rates of utilization of these therapies. The authors analyzed the Minnesota Heart Survey, a population-based surveillance project that retrospectively abstracted the medical records of patients hospitalized with AMI in 2001-2002 from 21 hospitals in the Minneapolis-St Paul metropolitan area. They identified 2773 patients 30 years and older with an AMI. The mean total cholesterol was 175+/-45 mg/dL, the mean low-density lipoprotein cholesterol was 104+/-38 mg/dL, and the mean high-density lipoprotein cholesterol was 44+/-14 mg/dL. Statins were prescribed at discharge to 74.6%, 63.2%, and 38.5% of patients younger than 65, 65-74, and 75 years and older, respectively (P<.0001). The utilization of statins was highly correlated with the administration of other standard AMI therapies-aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and reperfusion therapy-and was more prevalent among patients undergoing percutaneous coronary intervention than among those undergoing coronary artery bypass surgery. Elderly patients remain less likely to receive lipid-lowering therapy following an AMI. Greater attention is required to ensure that elderly AMI patients without contraindications are appropriately treated with lipid-lowering therapy.
Berger
Alan K
AK
Section of Cardiovascular Medicine, Department of Medicine, and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA. berger1217@aol.com
Duval
Susan J
SJ
Armstrong
Chris
C
Jacobs
David R
DR
Luepker
Russell V
RV
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D017723:Drug Utilization Review / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery; D010351:Patient Discharge; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012189:Retrospective Studies
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors