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

Gunnar H Gislason, Jeppe Nørgaard Rasmussen, Steen Z Abildstrøm, Niels Gadsbøll, Pernille Buch, Jens Friberg, Søren Rasmussen, Lars Køber, Steen Stender, Mette Madsen, Christian Torp-Pedersen

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Abstract

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
Original languageEnglish
JournalEuropean Heart Journal
Volume27
Issue number10
Pages (from-to)1153-8
Number of pages5
ISSN0195-668X
DOIs
Publication statusPublished - 2006

Bibliographical note

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

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