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Impact of combined secondary prevention therapy after myocardial infarction: data from a nationwide French registry.
Am Heart J. 2005 Dec; 150(6):1147-53.AH

Abstract

BACKGROUND

Several classes of medications improve survival in patients with coronary artery disease. Whether these medications, as used in the real world, have additive efficacy remains speculative.

OBJECTIVES

To assess whether patients discharged on combined secondary prevention medications after acute myocardial infarction (AMI) have improved 1-year survival, compared with the action of any single class of medications.

DESIGN AND SETTING

Nationwide registry of consecutive patients admitted to intensive care units for AMI in November 2000 in France. Multivariate Cox regression analysis, including a propensity score for the prescription of combined therapy, was used.

RESULTS

Of the 2119 patients discharged alive, 1095 (52%) were prescribed a combination of antiplatelet agents, beta-blockers, and statins (triple therapy), of whom 567 (27%) also received angiotensin-converting enzyme inhibitors (quadruple therapy) and 528 (25%) did not. One-year survival was 97% in patients receiving triple combination therapy versus 88% in those who received either none, 1, or 2 of these medications (P < .0001). After multivariate adjustment including the propensity score, the hazard ratio for 1-year mortality in patients with triple combination therapy was 0.52 (95% CI 0.33-0.81). In patients with ejection fraction < or = 35%, beta-blockers and angiotensin-converting enzyme inhibitors were independent predictors of survival, and combination therapy had no additional prognostic value.

CONCLUSIONS

Compared with the prescription of any single class of secondary prevention medications, combination therapy offers additional protection in patients with AMI.

Authors+Show Affiliations

Hôpital Européen Georges Pompidou, Paris, France. nicolas.danchin@egp.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

16338251

Citation

Danchin, Nicolas, et al. "Impact of Combined Secondary Prevention Therapy After Myocardial Infarction: Data From a Nationwide French Registry." American Heart Journal, vol. 150, no. 6, 2005, pp. 1147-53.
Danchin N, Cambou JP, Hanania G, et al. Impact of combined secondary prevention therapy after myocardial infarction: data from a nationwide French registry. Am Heart J. 2005;150(6):1147-53.
Danchin, N., Cambou, J. P., Hanania, G., Kadri, Z., Genès, N., Lablanche, J. M., Blanchard, D., Vaur, L., Clerson, P., & Guéret, P. (2005). Impact of combined secondary prevention therapy after myocardial infarction: data from a nationwide French registry. American Heart Journal, 150(6), 1147-53.
Danchin N, et al. Impact of Combined Secondary Prevention Therapy After Myocardial Infarction: Data From a Nationwide French Registry. Am Heart J. 2005;150(6):1147-53. PubMed PMID: 16338251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of combined secondary prevention therapy after myocardial infarction: data from a nationwide French registry. AU - Danchin,Nicolas, AU - Cambou,Jean-Pierre, AU - Hanania,Guy, AU - Kadri,Zena, AU - Genès,Nathalie, AU - Lablanche,Jean-Marc, AU - Blanchard,Didier, AU - Vaur,Laurent, AU - Clerson,Pierre, AU - Guéret,Pascal, AU - ,, PY - 2004/11/04/received PY - 2005/01/18/accepted PY - 2005/12/13/pubmed PY - 2006/2/16/medline PY - 2005/12/13/entrez SP - 1147 EP - 53 JF - American heart journal JO - Am Heart J VL - 150 IS - 6 N2 - BACKGROUND: Several classes of medications improve survival in patients with coronary artery disease. Whether these medications, as used in the real world, have additive efficacy remains speculative. OBJECTIVES: To assess whether patients discharged on combined secondary prevention medications after acute myocardial infarction (AMI) have improved 1-year survival, compared with the action of any single class of medications. DESIGN AND SETTING: Nationwide registry of consecutive patients admitted to intensive care units for AMI in November 2000 in France. Multivariate Cox regression analysis, including a propensity score for the prescription of combined therapy, was used. RESULTS: Of the 2119 patients discharged alive, 1095 (52%) were prescribed a combination of antiplatelet agents, beta-blockers, and statins (triple therapy), of whom 567 (27%) also received angiotensin-converting enzyme inhibitors (quadruple therapy) and 528 (25%) did not. One-year survival was 97% in patients receiving triple combination therapy versus 88% in those who received either none, 1, or 2 of these medications (P < .0001). After multivariate adjustment including the propensity score, the hazard ratio for 1-year mortality in patients with triple combination therapy was 0.52 (95% CI 0.33-0.81). In patients with ejection fraction < or = 35%, beta-blockers and angiotensin-converting enzyme inhibitors were independent predictors of survival, and combination therapy had no additional prognostic value. CONCLUSIONS: Compared with the prescription of any single class of secondary prevention medications, combination therapy offers additional protection in patients with AMI. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16338251/Impact_of_combined_secondary_prevention_therapy_after_myocardial_infarction:_data_from_a_nationwide_French_registry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00539-9 DB - PRIME DP - Unbound Medicine ER -