TY - JOUR

T1 - Long-term compliance with beta-blockers, angiotensin-converting enzyme inhibitors, and statins after acute myocardial infarction.

AU - Gislason, Gunnar H

AU - Rasmussen, Jeppe Nørgaard

AU - Abildstrøm, Steen Z

AU - Gadsbøll, Niels

AU - Buch, Pernille

AU - Friberg, Jens

AU - Rasmussen, Søren

AU - Køber, Lars

AU - Stender, Steen

AU - Madsen, Mette

AU - Torp-Pedersen, Christian

N1 - Keywords: Adrenergic beta-Antagonists; Aged; Angiotensin-Converting Enzyme Inhibitors; Denmark; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Multivariate Analysis; Myocardial Infarction; Patient Compliance; Treatment Outcome

PY - 2006

Y1 - 2006

N2 - AIMS: To study initiation, dosages, and compliance with beta-blockers, angiotensin-converting enzyme (ACE)-inhibitors, and statins in patients after acute myocardial infarction (AMI) and to identify likely targets for improvement. METHODS AND RESULTS: Patients admitted with first AMI between 1995 and 2002 were identified by linking nationwide administrative registers. A total of 55 315 patients survived 30 days after discharge and were included; 58.3% received beta-blockers, 29.1% ACE-inhibitors, and 33.5% statins. After 1, 3, and 5 years, 78, 64, and 58% of survivors who had started therapy were still receiving beta-blockers, 86, 78, and 74% were receiving ACE-inhibitors, and 85, 80, and 82% were receiving statins, respectively. Increased age and female sex were associated with improved compliance. The dosages prescribed were generally 50% or less of the dosages used in clinical trials, and dosages did not increase during the observation period. Patients who did not start treatment shortly after discharge had a low probability of starting treatment later. CONCLUSION: The main problem with underuse of recommended treatment after AMI is that treatment is not initiated at an appropriate dosage shortly after AMI. A focused effort in the immediate post-infarction period would appear to provide long-term benefit. Udgivelsesdato: 2006-May

AB - AIMS: To study initiation, dosages, and compliance with beta-blockers, angiotensin-converting enzyme (ACE)-inhibitors, and statins in patients after acute myocardial infarction (AMI) and to identify likely targets for improvement. METHODS AND RESULTS: Patients admitted with first AMI between 1995 and 2002 were identified by linking nationwide administrative registers. A total of 55 315 patients survived 30 days after discharge and were included; 58.3% received beta-blockers, 29.1% ACE-inhibitors, and 33.5% statins. After 1, 3, and 5 years, 78, 64, and 58% of survivors who had started therapy were still receiving beta-blockers, 86, 78, and 74% were receiving ACE-inhibitors, and 85, 80, and 82% were receiving statins, respectively. Increased age and female sex were associated with improved compliance. The dosages prescribed were generally 50% or less of the dosages used in clinical trials, and dosages did not increase during the observation period. Patients who did not start treatment shortly after discharge had a low probability of starting treatment later. CONCLUSION: The main problem with underuse of recommended treatment after AMI is that treatment is not initiated at an appropriate dosage shortly after AMI. A focused effort in the immediate post-infarction period would appear to provide long-term benefit. Udgivelsesdato: 2006-May

U2 - 10.1093/eurheartj/ehi705

DO - 10.1093/eurheartj/ehi705

M3 - Journal article

C2 - 16399775

VL - 27

SP - 1153

EP - 1158

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 10

ER -