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Contemporary Trends of Optimal Evidence-Based Medical Therapy at Discharge for Patients Surviving Acute Myocardial Infarction From the Korea Acute Myocardial Infarction Registry

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Author(s)
Jang Hoon LeeMyung Hwan BaeDong Heon YangHun Sik ParkYongkeun ChoMyung Ho JeongYoung Jo KimKee-Sik KimSeung Ho HurIn Whan SeongMyeong Chan ChoChong Jin KimShung Chull Chae
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Clinical Cardiology
Issued Date
2015
Volume
38
Issue
6
Abstract
Background


Temporal trends of evidence-based optimal medical therapy (OMT) at discharge after acute myocardial infarction (AMI) have not been investigated in recent years.


Hypothesis


OMT should have been increased in AMI and gap between guidelines and practices in its use should have been narrowed.


Methods


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.


Results


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.


Conclusions


Despite gradual increase in OMT over time, the gap between guidelines and practices in use of OMT continues to exist
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Jang Hoon Lee et al. (2015). Contemporary Trends of Optimal
Evidence-Based Medical Therapy at
Discharge for Patients Surviving Acute
Myocardial Infarction From the Korea Acute
Myocardial Infarction Registry. Clinical Cardiology, 38(6), 350–356. doi: 10.1002/clc.22396
Type
Article
ISSN
0160-9289
DOI
10.1002/clc.22396
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35442
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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