Contemporary trends in evidence-based treatment for acute myocardial infarction.
BACKGROUND
Guidelines for the management of patients with acute myocardial infarction recommend the routine use of 4 effective cardiac medications: angiotensin-converting enzyme inhibitors, aspirin, beta-blockers, and lipid-lowering agents. Limited data are available, however, about the contemporary and changing use of these therapies, particularly from a population-based perspective. The study describes differences in the use of these medications during hospitalization for acute myocardial infarction according to age, gender, and period of hospitalization.


METHODS
The study population consisted of 6334 women and men treated at 11 hospitals in the Worcester, Mass, metropolitan area for acute myocardial infarction in 6 annual periods between 1995 and 2005.


RESULTS
Increases in the use of all 4 cardiac medications during hospitalization for acute myocardial infarction were noted between 1995 and 2005 for all men and in those of different age strata: less than 65 years (4%-47%); 65 to 74 years (4%-46%); 75 to 84 years (2%-48%); and more than 85 years (0%-23%). Increases in the use of all 4 cardiac medications also were observed in all women and in those of all ages over time (2%-42%); 65 to 74 years (8%-47%); 75 to 84 years (1%-44%); and more than 85 years (1%-44%).


CONCLUSIONS
The present results suggest marked increases over time in the use of evidence-based therapies in patients hospitalized with acute myocardial infarction. Educational efforts to augment the use of these effective cardiac therapies, as well as attempts to identify suboptimally treated groups, remain warranted.
Fornasini
Marco
M
College of Health Sciences, Universidad San Francisco de Quito, Quito, Ecuador.
Yarzebski
Jorge
J
Chiriboga
David
D
Lessard
Darleen
D
Spencer
Frederick A
FA
Aurigemma
Philip
P
Gore
Joel M
JM
Goldberg
Robert J
RJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009204:Myocardial Revascularization; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents