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Does the presence of heart failure alter prescribing of drug therapy after myocardial infarction?
Author(s) -
Krum Henry
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb00818.x
Subject(s) - excellence , citation , medicine , myocardial infarction , library science , psychology , cardiology , computer science , political science , law
OBJECTIVETo evaluate the use of cardiovascular medications in patients with and without heart failure after myocardial infarction (MI).DESIGN AND SETTINGMulticentre study of drug therapy for patients with MI in 16 major metropolitan teaching hospitals in Australia over a 1-month period at each hospital in the period November 2004 - March 2005.PARTICIPANTS479 patients admitted consecutively to the individual hospitals.MAIN OUTCOME MEASURESProportion of patients with and without heart failure who were prescribed key cardiovascular medications after MI.RESULTS116 of the 479 patients admitted for MI (24.2%) had heart failure at some point during their hospitalisation. Patients with heart failure were older (68 v 63 years; P < 0.05), more likely to be women (34% v 24%; P < 0.05) and a higher proportion had diabetes (26% v 21%). There was significantly reduced prescribing of beta-blockers, clopidogrel and statins for patients with heart failure compared with those without heart failure. Mineralocorticoid receptor antagonist use was low (< 10%) in the former group.CONCLUSIONSWe found reduced prescribing of some prognostically relevant medications for patients with heart failure. For beta-blockers, this may be explained by the greater clinical instability in patients with heart failure. Given the absolute benefit of drug therapy in patients with heart failure after MI, our findings suggest suboptimal prescribing in Australian teaching hospital practice.