title: Retrospective review of in hospital use of mineralocorticoid receptor antagonists for high risk patients following myocardial infarction.
abstract: BACKGROUND
  There is little data regarding use of mineralocorticoid antagonists (MRAs) for patients reduced LV ejection fraction (LVEF) following acute myocardial infarction (MI). We determined the frequency and temporal trends of MRA use in these patients.
  
  
  METHODS
  We performed a retrospective review of all cases of acute MI between June 1, 2010 and April 1, 2012. Patients were considered eligible for MRA therapy if they were admitted with acute MI with LVEF ≤ 40 % and had heart failure symptoms or a history of diabetes.
  
  
  RESULTS
  Of 3910 cases of acute MI, 332 patients were considered eligible for MRA therapy. MRA therapy was prescribed for 92/332 (28 %) eligible patients, while 66 of 1142 (6 %) of ineligible patients were so treated. Over the study period, usage in eligible and ineligible patients rose significantly (22 to 30 %, p = 0.08 and 4 to 7 %, p = 0.04 respectively).
  
  
  CONCLUSIONS
  Prescription of MRAs for eligible patients occurred in a minority of patients, and demonstrated a modest increase over time. In patients without an indication for MRAs, a similar trend was observed. Further study is required to better understand barriers to appropriate use of MRAs in this patient population.
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, Room C-838, 1403-29th Street NW, Calgary, T2N 2Y8, AB, Canada.
authors.forename: Robert J H
authors.initials: RJ
authors.lastname: Miller
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, Room C-838, 1403-29th Street NW, Calgary, T2N 2Y8, AB, Canada. howlettjonathan@gmail.com.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Howlett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists