Use of secondary preventive medications after the first attack of acute coronary syndrome

Salomaa, Veikko; Pääkkönen, Rauni; Hämäläinen, Helena; Niemi, Marja; Klaukka, Timo

doi:10.1097/01.hjr.0000244573.10229.6e

Cited by 33 publications

(35 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with a similar population-based study in Finland [27], we found that beta-blocker initiation was inversely associated with age. In general, older individuals and those with conditions indicating illness and frailty were less likely to initiate beta-blockers after AMI.…”

Section: Adherence To Beta-blocker Therapysupporting

confidence: 80%

Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction

Maio

Marino

Robeson

et al. 2011

European Journal of Cardiovascular Prevention & Rehabilitat

View full text Add to dashboard Cite

Aims: We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy. Methods and Results: Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression analysis to identify independent predictors of post-AMI beta-blocker initiation. We computed the proportion of days covered (PCD) as a measure of medication adherence at 6 and 12 months post-discharge. Following discharge, 16,383 (67%) cohort members initiated beta-blocker therapy. Independent predictors of beta-blocker initiation included age and receipt of invasive procedures during hospitalization, such as coronary artery bypass graft surgery (odds ratio [OR], 2.37; 95% confidence interval [CI], 2.00–2.81), percutaneous transluminal coronary angioplasty (OR, 1.42; 95% CI, 1.31–1.54), and cardiac catheterization (OR, 1.21; 95% CI, 1.11–1.32). Among initiators, adherence to beta-blocker treatment at 6 and 12 months was low and decreased in each study year. Conclusion: Overall, use of and adherence to post-AMI beta-blocker therapy was suboptimal in RER between 2004 and 2007. Older patients and those with indicators of frailty were less likely to initiate therapy. The proportion of patients adherent at 6 and 12 months decreased over time.

show abstract

Section: Adherence To Beta-blocker Therapysupporting

confidence: 80%

Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction

Maio

Marino

Robeson

et al. 2011

European Journal of Cardiovascular Prevention & Rehabilitat

View full text Add to dashboard Cite

show abstract

“…Previous reports of disparities between clinical practices and trials suggested elderly persons, women, and comorbidities were negatively associated with statin use (22,23). In our subjects with CHD, the distributions of age and sex were similar, but the Charlson index was higher among controls (1.8 Ϯ 1.6 vs. 2.0 Ϯ 1.7, p Ͻ 0.001).…”

Section: Discussionmentioning

confidence: 55%

Statins, Risk of Diabetes, and Implications on Outcomes in the General Population

Wang

Liu

Chao

et al. 2012

Journal of the American College of Cardiology

117

View full text Add to dashboard Cite

show abstract

“…Furthermore, it is possible that towards the end of our study period type 2 diabetes was diagnosed earlier and treated with hypoglycaemic medication earlier than in the early 1990s. This argument is supported by the increased use of hypoglycaemic medications [26,27]. Accordingly, the later years close to 2002 may include more patients with a shorter history of diabetes and fewer complications.…”

Section: Discussionmentioning

confidence: 72%

Case fatality rates after first acute coronary syndrome in persons treated for type 2 diabetes show an improving trend

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis We analysed whether the prognosis of a first acute coronary syndrome (ACS) in patients treated for type 2 diabetes has improved. We also compared the trends in patients with and without diabetes. Methods We used national registers to identify all patients with clinically known type 2 diabetes in Finland during the years 1988 to 2002 (n=222,940). All first-ever ACS events (n=43,412) among these patients were identified using the Hospital Discharge Register and the Causes of Death Register. From the National Cardiovascular Disease Register we identified all first ACS attacks (n=191,403) among non-diabetic patients in the country. Finally, we calculated annual age-standardised case fatality rates for ACS for three time periods: prehospital, days 0 to 27 and days 28 to 364 after the first ACS. Results The case fatality rate of first ACS declined significantly in both sexes at all time points considered. The declining trends were not different between patients with type 2 diabetes and those without. Among men aged 35 to 74 years, 58.5% (95% CI 57.6-59.4%) with type 2 diabetes and 44.1% (95% CI 43.8-44.5%) without diabetes had died from cardiovascular causes 1 year after their first ACS. Among women of the same age, the corresponding figures were 54.2% (95% CI 53.0-55.4%) and 36.5% (95% CI 35.9-37.1%). Men generally had higher case fatality rates than women. However, except for prehospital deaths, diabetic women had the same or even higher case fatality rates than non-diabetic men. Conclusions/interpretation The case fatality rates for first ACS show similar improving trends in patients with type 2 diabetes and in those without. However, case fatality rates have remained higher in patients with type 2 diabetes.

show abstract

Use of secondary preventive medications after the first attack of acute coronary syndrome

Abstract: Our study showed that the evidence-based use of medications after acute coronary syndrome was suboptimal in Finland, particularly in elderly and diabetic patients. Consistent use of these medications, however, was associated with a better prognosis.

Cited by 33 publications

References 27 publications

Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction

Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction

Statins, Risk of Diabetes, and Implications on Outcomes in the General Population

Case fatality rates after first acute coronary syndrome in persons treated for type 2 diabetes show an improving trend

Contact Info

Product

Resources

About