[Secondary prevention of ischemic heart disease: pharmacological treatment after myocardial infarction according to follow-up protocol].
The aim of this work was to assess the quality of pharmacological treatment in patients within one year after acute myocardial infarction.


METHODS
We performed a prospective survey of 985 consecutive patients with acute myocardial infarction who were treated in the Clinic of Cardiology of Kaunas University of Medicine Hospital in 2004. About half of patients were hospitalized from different regions of Lithuania. According to the follow-up protocol, an information on 514 patients and their used treatment within 13.8+/-3.2 months after myocardial infarction were collected by letter with questionnaire.


RESULTS
Beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotic drugs were the most drug used (76%, 74%, and 76%, respectively) in patients following myocardial infarction. Most of the patients used a three-drug combination (36.8%), more rarely--two-drug (24.1%) or four-drug complex (19.8%). One drug was used only in 12.1% of cases; 7.2% of patients did not use any cardiac drugs. Beta-adrenoblocker with angiotensin-converting enzyme inhibitor was the most common (40.3%) used drug combination in patients on two drug complex. The combination of beta-adrenoblocker, angiotensin-converting enzyme inhibitor, and antithrombotics was more frequently used in patients on three drug complex. The combination of two or three cardiac drugs with statin was used in several cases (1.6-10.3%).


CONCLUSIONS
These findings underscore that the use of beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotics was high (about 75%) in patients during the first year after myocardial infarction, and the combination of these three drugs was used more commonly. The discordance between existing guidelines for statin use after myocardial infarction and current practice was determined in patients following myocardial infarction.
Milvidaite
Irena
I
Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania. irena.milvidaite@kmuk.lt
Luksiene
Dalia
D
Slapikiene
Birute
B
Babarskiene
Marija Rūta
MR
Liukaitis
Valdas
V
Maciulaitis
Romas
R
Kadusevicius
Edmundas
E
Pilviniene
Rugile
R
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002985:Clinical Protocols; D001026:Coronary Artery Bypass; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017202:Myocardial Ischemia / Q000517:prevention & control*; D009566:Nitrates / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents; D009566:Nitrates