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Ten-year trends of cardiovascular drug use after myocardial infarction among community-dwelling persons > or =65 years of age.
Am J Cardiol. 2007 Oct 01; 100(7):1061-7.AJ

Abstract

Guidelines for post-myocardial infarction (MI) management emphasize treatment with statins, beta blockers (BBs), and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs). Little is known about the temporal trends and racial differences in such use after discharge. This study assessed temporal trends and racial differences in the use of statins, BBs, and ACEIs or ARBs after MI discharge in community-dwelling seniors. Administrative data from pharmacy assistance programs and Medicare in 2 states (1995 to 2004) were used to identify all patients hospitalized for MI who survived > or =90 days after discharge. Age, gender, race, co-morbidities, and MI-specific procedures during hospitalization were assessed. The study outcomes were filled prescriptions for any statin, BB, or ACEI or ARB <90 days after discharge. Multivariate regression was used for trend and racial difference analyses. Of 19,368 patients identified, 6,577 (34.0%) filled prescriptions for statins, 12,387 (64.0%) for BBs, and 9,934 (51.3%) for ACEIs or ARBs <90 days after MI discharge. The use of these drugs increased from 1995 to 2004, most steeply for statins (11% to 61%), less so for BBs (47% to 80%), and least for ACEIs or ARBs (46% to 58%) (all p for trend <0.001). Black patients were 14% and 5% less likely to receive statins and BBs, respectively (all p <0.05). No evidence of an interaction between race and time trend was found. In conclusion, the use of cardiovascular medications after discharge from MI hospitalization in older patients may still be inadequate but has increased over time. The underuse of statins and BBs was marked in black patients and did not improve over time.

Authors+Show Affiliations

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. ssetoguchi@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17884362

Citation

Setoguchi, Soko, et al. "Ten-year Trends of Cardiovascular Drug Use After Myocardial Infarction Among Community-dwelling Persons > or =65 Years of Age." The American Journal of Cardiology, vol. 100, no. 7, 2007, pp. 1061-7.
Setoguchi S, Glynn RJ, Avorn J, et al. Ten-year trends of cardiovascular drug use after myocardial infarction among community-dwelling persons > or =65 years of age. Am J Cardiol. 2007;100(7):1061-7.
Setoguchi, S., Glynn, R. J., Avorn, J., Levin, R., & Winkelmayer, W. C. (2007). Ten-year trends of cardiovascular drug use after myocardial infarction among community-dwelling persons > or =65 years of age. The American Journal of Cardiology, 100(7), 1061-7.
Setoguchi S, et al. Ten-year Trends of Cardiovascular Drug Use After Myocardial Infarction Among Community-dwelling Persons > or =65 Years of Age. Am J Cardiol. 2007 Oct 1;100(7):1061-7. PubMed PMID: 17884362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ten-year trends of cardiovascular drug use after myocardial infarction among community-dwelling persons > or =65 years of age. AU - Setoguchi,Soko, AU - Glynn,Robert J, AU - Avorn,Jerry, AU - Levin,Raisa, AU - Winkelmayer,Wolfgang C, Y1 - 2007/07/30/ PY - 2007/03/16/received PY - 2007/04/25/revised PY - 2007/04/25/accepted PY - 2007/9/22/pubmed PY - 2007/11/6/medline PY - 2007/9/22/entrez SP - 1061 EP - 7 JF - The American journal of cardiology JO - Am J Cardiol VL - 100 IS - 7 N2 - Guidelines for post-myocardial infarction (MI) management emphasize treatment with statins, beta blockers (BBs), and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs). Little is known about the temporal trends and racial differences in such use after discharge. This study assessed temporal trends and racial differences in the use of statins, BBs, and ACEIs or ARBs after MI discharge in community-dwelling seniors. Administrative data from pharmacy assistance programs and Medicare in 2 states (1995 to 2004) were used to identify all patients hospitalized for MI who survived > or =90 days after discharge. Age, gender, race, co-morbidities, and MI-specific procedures during hospitalization were assessed. The study outcomes were filled prescriptions for any statin, BB, or ACEI or ARB <90 days after discharge. Multivariate regression was used for trend and racial difference analyses. Of 19,368 patients identified, 6,577 (34.0%) filled prescriptions for statins, 12,387 (64.0%) for BBs, and 9,934 (51.3%) for ACEIs or ARBs <90 days after MI discharge. The use of these drugs increased from 1995 to 2004, most steeply for statins (11% to 61%), less so for BBs (47% to 80%), and least for ACEIs or ARBs (46% to 58%) (all p for trend <0.001). Black patients were 14% and 5% less likely to receive statins and BBs, respectively (all p <0.05). No evidence of an interaction between race and time trend was found. In conclusion, the use of cardiovascular medications after discharge from MI hospitalization in older patients may still be inadequate but has increased over time. The underuse of statins and BBs was marked in black patients and did not improve over time. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/17884362/Ten_year_trends_of_cardiovascular_drug_use_after_myocardial_infarction_among_community_dwelling_persons_>_or_=65_years_of_age_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)01241-6 DB - PRIME DP - Unbound Medicine ER -