6 International Research and 0 inion ~~~~~~~~~~~~~~~--~------~~~---At-risk patients with MI don't get the best possible care

Many patients with acute myocardial infarction (MI) who are at high risk for adverse clinical outcomes while in hospital receive inadequate care, indicate the findings of a large US study.

Specifically, < 60% of high-risk patients receive reperfusion therapy, and not all patients are prescribed aspirin and 13-blockers. Only about 50% of high-risk patients receive oral or IV 13-blockers within 24 hours of hospital admission, whereas 80% are given aspirin. At hospital discharge, 13-blockers and aspirin are prescribed to around 50 and 70% of high-risk patients, respectively.

These results were based on an analysis of > 170 000 patients enrolled in the US National Registry of Myocardial Infarction-2 (NRMI-2) database. Patients were classified as high (n =55 521) or low (115 222) risk according to modified Thrombolysis in Myocardial Infarction (TIMI) II risk-stratification criteria. Becker RC, Burns M, Gore JM, National Registry of Myocardial Infarction. Early assessment and in-hospital management of patients with acute myocardial infarction at increased risk for adverse outcomes: a nationwide perspective of current clinical practice. American Heart Journal135: 786-796, Part 1, May 1998 &00676489

PhannacoEconomics & Outcomes News4 Jul1998 No. 169 1173-5503/9B/0169-0006/$01.00c Adis International Limited 1998. All rights reserved