Contemporary Trends of Optimal
Evidence-Based Medical Therapy at
Discharge for Patients Surviving Acute
Myocardial Infarction From the Korea Acute
Myocardial Infarction Registry
- Affiliated Author(s)
- Alternative Author(s)
- Hur, Seung Ho
- Journal Title
- Clinical Cardiology
- Issued Date
Temporal trends of evidence-based optimal medical therapy (OMT) at discharge after acute myocardial infarction (AMI) have not been investigated in recent years.
OMT should have been increased in AMI and gap between guidelines and practices in its use should have been narrowed.
We examined discharge medications of 17,578 post-MI patients who had no documented contraindications to antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors, or statins across a 6-year period (divided into subperiods of November 2005 to December 2006 [period 1], 2007 [period 2], 2008 [period 3], 2009 [period 4], 2010 [period 5], and January to June 2011 [period 6]) in the Korean AMI Registry. OMT was defined as use of all 4 indicated medications.
Marked increases in OMT (48.6% to 63.2%) were seen irrespective of age and sex, mainly attributed to marked increases in the use of β-blockers (70.3% to 83.7%) and statins (76.9% to 82.6%) from period 1 to period 6. The gap in use of OMT between men and women narrowed over time between the first and second 3 periods, but not between the young and the elderly. Advanced age (odds ratio [OR]: 0.88, P = 0.04) was independently associated with underuse of OMT. Adjusted ORs for OMT from period 1 to period 6 were as follows: 1, 1.14 (P = 0.024), 1.21 (P = 0.001), 1.40 (P < 0.001), 1.47 (P < 0.001), and 1.69 (P < 0.001), respectively.
Despite gradual increase in OMT over time, the gap between guidelines and practices in use of OMT continues to exist
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