European Heart Journal Advance Access originally published online on January 6, 2006
European Heart Journal 2006 27(10):1153-1158; doi:10.1093/eurheartj/ehi705
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Long-term compliance with beta-blockers, angiotensin-converting enzyme inhibitors, and statins after acute myocardial infarction
1 Department of Cardiovascular Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark
2 National Institute of Public Health, Copenhagen, Denmark
3 Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
4 Department of Internal Medicine, Roskilde County Hospital, Roskilde, Denmark
5 Department of Cardiology, The Heart Centre, Rigshospitalet—National University Hospital, Copenhagen, Denmark
6 Clinical Biochemistry, Gentofte University Hospital, Hellerup, Denmark
Received 10 October 2005; revised 5 December 2005; accepted 8 December 2005; online publish-ahead-of-print 6 January 2006.
* Corresponding author. Tel: +45 3531 3328; fax: +45 3975 1803. E-mail address: gg{at}heart.dk
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.
Key Words: Acute myocardial infarction • Beta-blockers • ACE-inhibitors • Statins • Pharmacological treatment • Compliance
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K. Swedberg, M. Komajda, M. Bohm, J. S. Borer, I. Ford, and L. Tavazzi Rationale and design of a randomized, double-blind, placebo-controlled outcome trial of ivabradine in chronic heart failure: the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT) Eur J Heart Fail, November 5, 2009; (2009) hfp154v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fox, I. Ford, Ph. G. Steg, M. Tendera, M. Robertson, R. Ferrari, and on behalf of the BEAUTIFUL Investigators Relationship between ivabradine treatment and cardiovascular outcomes in patients with stable coronary artery disease and left ventricular systolic dysfunction with limiting angina: a subgroup analysis of the randomized, controlled BEAUTIFUL trial Eur. Heart J., October 1, 2009; 30(19): 2337 - 2345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Bagi Mechanisms of coronary microvascular adaptation to obesity Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2009; 297(3): R556 - R567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-C. Tardif, P. Ponikowski, T. Kahan, and for the ASSOCIATE study Investigators Efficacy of the If current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial Eur. Heart J., March 1, 2009; 30(5): 540 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sajadieh A new combination therapy in stable angina pectoris Eur. Heart J., March 1, 2009; 30(5): 524 - 525. [Full Text] [PDF]
|
|
|
|
 |
|
 G. H. Gislason, J. N. Rasmussen, S. Z. Abildstrom, T. K. Schramm, M. L. Hansen, E. L. Fosbol, R. Sorensen, F. Folke, P. Buch, N. Gadsboll, et al. Increased Mortality and Cardiovascular Morbidity Associated With Use of Nonsteroidal Anti-inflammatory Drugs in Chronic Heart Failure Arch Intern Med, January 26, 2009; 169(2): 141 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. N Rasmussen, G. H Gislason, S. Rasmussen, S. Z Abildstrom, T. K Schramm, L. Kober, F. Diderichsen, M. Osler, C. Torp-Pedersen, and M. Madsen Use of statins and beta-blockers after acute myocardial infarction according to income and education J Epidemiol Community Health, December 1, 2007; 61(12): 1091 - 1097. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bangalore, F. H. Messerli, J. B. Kostis, and C. J. Pepine Cardiovascular Protection Using Beta-Blockers: A Critical Review of the Evidence J. Am. Coll. Cardiol., August 14, 2007; 50(7): 563 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. H. Gislason, J. N. Rasmussen, S. Z. Abildstrom, T. K. Schramm, M. L. Hansen, P. Buch, R. Sorensen, F. Folke, N. Gadsboll, S. Rasmussen, et al. Persistent Use of Evidence-Based Pharmacotherapy in Heart Failure Is Associated With Improved Outcomes Circulation, August 14, 2007; 116(7): 737 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. N. Rasmussen, A. Chong, and D. A. Alter Relationship Between Adherence to Evidence-Based Pharmacotherapy and Long-term Mortality After Acute Myocardial Infarction JAMA, January 10, 2007; 297(2): 177 - 186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. H. Gislason, S. Jacobsen, J. N. Rasmussen, S. Rasmussen, P. Buch, J. Friberg, T. K. Schramm, S. Z. Abildstrom, L. Kober, M. Madsen, et al. Risk of Death or Reinfarction Associated With the Use of Selective Cyclooxygenase-2 Inhibitors and Nonselective Nonsteroidal Antiinflammatory Drugs After Acute Myocardial Infarction Circulation, June 27, 2006; 113(25): 2906 - 2913. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Post-MI Therapies: Initiation and Adherence Journal Watch Cardiology, June 8, 2006; 2006(608): 4 - 4. [Full Text]
|
|