us treatment of acute mi less than ideal

INTERNATIONAL RESEARCH & OPINION US treatment of acute MI less than ideal Recommended treatments for acute myocardial infarction (Ml) are not reaching all patients who could benefit from them, say researchers for the US Health Care Financing Administration Cooperative Cardiovascular Project (CCP). Using CCP data for 186 000 patients who received treatment for acute MI at an acute-care hospital in one of 50 US states, the researchers estimated what proportion of patients who were considered ideal for specific therapies actually received them.* Aspirin and !3-blockers underused Around 14% of patients who were considered ideal for aspirin therapy did not receive this drug during hospitalisation and 22% did not receive it at discharge. Moreover, 50% of patients did not receive therapy, 41% did not receive ACE inhibitors, and 33% did not undergo reperfusion using thrombolytic therapy or percutaneous transluminal coronary angioplasty. Calcium antagonists were given to 18% of patients with left ventricular dysfunction, despite the fact that these agents are not generally recommended in the acute or long-term treatment of patients with acute MI. 58% of identified smokers had no documented evidence of receiving smoking cessation advice. The researchers noted that there was wide geographical variation in treatment patterns for acute MI . * The specific therapies investigated were based on treatment guidelines for acute MI published by the American College of Cardiology, the American Heart Association and expert consensus. O'Connor GT. Quinton HB. Traven ND. Ramunno LD. Dodds TA, eta!. Geographic variation in the treatment of acute myocardial infarction: the Cooperative Cardiovascular Project. Journal of the American Medical Association 281:627-633, 17 Feb 1999 ")()""" 1173·5503/99/0201·0009/$01.00c Adis International Limited 1999. All rights reserved PharmacoEconomiCS & Outcomes News 27 Feb 1999 No. 201 9

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INTERNATIONAL RESEARCH & OPINION

US treatment of acute MI less than ideal

Recommended treatments for acute myocardial infarction (Ml) are not reaching all patients who could benefit from them, say researchers for the US Health Care Financing Administration Cooperative Cardiovascular Project (CCP).

Using CCP data for 186 000 patients who received treatment for acute MI at an acute-care hospital in one of 50 US states, the researchers estimated what proportion of patients who were considered ideal for specific therapies actually received them.*

Aspirin and !3-blockers underused Around 14% of patients who were considered ideal

for aspirin therapy did not receive this drug during hospitalisation and 22% did not receive it at discharge. Moreover, 50% of patients did not receive ~-blocker therapy, 41% did not receive ACE inhibitors, and 33% did not undergo reperfusion using thrombolytic therapy or percutaneous transluminal coronary angioplasty.

Calcium antagonists were given to 18% of patients with left ventricular dysfunction, despite the fact that these agents are not generally recommended in the acute or long-term treatment of patients with acute MI. 58% of identified smokers had no documented evidence of receiving smoking cessation advice.

The researchers noted that there was wide geographical variation in treatment patterns for acute MI . * The specific therapies investigated were based on treatment guidelines for acute MI published by the American College of Cardiology, the American Heart Association and expert consensus. O'Connor GT. Quinton HB. Traven ND. Ramunno LD. Dodds TA, eta!. Geographic variation in the treatment of acute myocardial infarction: the Cooperative Cardiovascular Project. Journal of the American Medical Association 281:627-633, 17 Feb 1999 ")()"""

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