title: Contemporary Trends of Optimal Evidence-Based Medical Therapy at Discharge for Patients Surviving Acute Myocardial Infarction From the Korea Acute Myocardial Infarction Registry.
abstract: BACKGROUND
  Temporal trends of evidence-based optimal medical therapy (OMT) at discharge after acute myocardial infarction (AMI) have not been investigated in recent years.
  
  
  OBJECTIVE
  OMT should have been increased in AMI and gap between guidelines and practices in its use should have been narrowed.
  
  
  METHODS
  We examined discharge medications of 17,578 post-MI patients who had no documented contraindications to antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors, or statins across a 6-year period (divided into subperiods of November 2005 to December 2006 [period 1], 2007 [period 2], 2008 [period 3], 2009 [period 4], 2010 [period 5], and January to June 2011 [period 6]) in the Korean AMI Registry. OMT was defined as use of all 4 indicated medications.
  
  
  RESULTS
  Marked increases in OMT (48.6% to 63.2%) were seen irrespective of age and sex, mainly attributed to marked increases in the use of β-blockers (70.3% to 83.7%) and statins (76.9% to 82.6%) from period 1 to period 6. The gap in use of OMT between men and women narrowed over time between the first and second 3 periods, but not between the young and the elderly. Advanced age (odds ratio [OR]: 0.88, P = 0.04) was independently associated with underuse of OMT. Adjusted ORs for OMT from period 1 to period 6 were as follows: 1, 1.14 (P = 0.024), 1.21 (P = 0.001), 1.40 (P < 0.001), 1.47 (P < 0.001), and 1.69 (P < 0.001), respectively.
  
  
  CONCLUSIONS
  Despite gradual increase in OMT over time, the gap between guidelines and practices in use of OMT continues to exist.
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Republic of Korea.
authors.forename: Kee-Sik
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Kyung Hee University East-west Neo Medical Center, Seoul, Republic of Korea.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056911:Democratic People's Republic of Korea; D019317:Evidence-Based Medicine / Q000639:trends*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D010351:Patient Discharge; D010818:Practice Patterns, Physicians' / Q000639:trends; D011446:Prospective Studies; D012042:Registries; D017741:Survivors
chemical_list: D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors