Is prophylactic treatment after myocardial infarction evidence-based?

Fam Pract. 1998 Oct;15(5):457-61. doi: 10.1093/fampra/15.5.457.

Abstract

Objective: We aimed to evaluate the use of evidence-based prophylactic treatment after myocardial infarction on hospital discharge and in primary care after 1 year of hospitalization.

Methods and results: We conducted a 1-year prospective study of all the patients discharged from a tertiary hospital who had been treated for myocardial infarction from January 1 to December 31 1995. Three hundred and eighty surviving patients were consecutively discharged from the hospital. Seventy per cent of patients were treated with aspirin, 45% with beta-blockers, 27% with calcium channel blockers, 26% with ACE inhibitors, 40% with nitrates and 8% with cholesterol-lowering drugs after discharge from the hospital. In primary care, prescription of lipid-lowering drugs increased to 17%, while prescription of beta-blockers decreased to 34%. ACE inhibitor prescriptions at discharge were clearly more common in patients with impaired ventricular function or heart failure (57%).

Conclusion: According to the evidence, there is still potential for reducing the risk of a further ischaemic event or death in patients with MI, especially by increasing the use of beta-blockers and lipid-lowering drugs.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Anticholesteremic Agents / therapeutic use
  • Aspirin / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Cardiovascular Agents / therapeutic use*
  • Evidence-Based Medicine*
  • Family Practice
  • Female
  • Humans
  • Male
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / prevention & control*
  • Nitroglycerin / therapeutic use
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Spain
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Anticholesteremic Agents
  • Calcium Channel Blockers
  • Cardiovascular Agents
  • Platelet Aggregation Inhibitors
  • Vasodilator Agents
  • Nitroglycerin
  • Aspirin