title: [Drug treatment adjustment to the clinical guidelines in octagenarians with acute myocardial infarction].
abstract: OBJECTIVE
  To determine whether there is a linear association of age and aspirin, betablockers, angiotensin-converting enzyme inhibitors and statins; the extent to which elderly patients receive these treatments; and whether age is independently associated with these treatments.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Coronary Unit of two hospitals in the Region of Murcia (Spain).
  
  
  METHODS
  Consecutive patients admitted with the diagnosis of acute myocardial infarction between January 1998 and January 2008.
  
  
  METHODS
  None.
  
  
  RESULTS
  Those related to the administration of aspirin, betablockers, angiotensin-converting enzyme inhibitors and statins during stay in the Coronary Care Unit.
  
  
  RESULTS
  Regarding the remaining patients, octogenarians received a similar proportion of angiotensin-converting enzyme inhibitors (70.8% vs. 69.3%, p=0.41) and less often aspirin (90.4% vs. 94.6%, p<0.001), betablockers (44.4% vs. 69.4%, p<0,001) and statins (47.6% vs. 64.7%, p<0.001). We were only able to demonstrate an abrupt and significant decrease in the use of statins after 80 years of age. Patient age was independently associated with the use of betablockers (OR 0.59; 95%CI 0.47 - 0.73) and statins (OR 0.78; 95%CI 0.65 - 0.95). The lesser administration of these drugs was also associated with early mortality (OR 0.17, 95%CI 0.09 to 0.33 and OR 0.14; 95%CI 0.08 to 0.23, respectively).
  
  
  CONCLUSIONS
  Octogenarians less often receive aspirin, betablockers and statins, though old age was not an independent factor associated with lesser aspirin use.
authors: Unidad Coronaria, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España. apadilla@jccm.es
authors: A
authors: A
authors: Padilla-Serrano
authors: J
authors: J
authors: Galcerá-Tomás
authors: A
authors: A
authors: Melgarejo-Moreno
authors: J M
authors: JM
authors: Tenías-Burillo
authors: N
authors: N
authors: Alonso-Fernández
authors: E
authors: E
authors: Andreu-Soler
authors: P
authors: P
authors: Rodríguez-García
authors: M D
authors: MD
authors: del Rey-Carrión
authors: A
authors: A
authors: Díaz-Pastor
authors: J H
authors: JH
authors: de Gea-García
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors