Communitywide trends in the use and outcomes associated with beta-blockers in patients with acute myocardial infarction: the Worcester Heart Attack Study
Authors
Silvet, HelmeSpencer, Frederick A.
Yarzebski, Jorge L.
Lessard, Darleen M.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2003-10-15Keywords
Adrenergic beta-AntagonistsAged
Comorbidity
Female
Humans
Male
Massachusetts
Middle Aged
Multivariate Analysis
Myocardial Infarction
Physician's Practice Patterns
Survival Analysis
Treatment Outcome
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Despite the benefits associated with beta-blocker therapy in patients with acute myocardial infarction (AMI), limited recent data are available describing the extent of use of this therapy and the associated hospital and long-term outcomes, particularly from the perspective of a population-based study. Data are also limited about the characteristics of patients with AMI who do not receive beta-blockers. This study examines more than 2 decades of trends in the use of beta-blockers in hospitalized patients with AMI. METHODS: Communitywide study of 10,374 patients hospitalized with confirmed AMI in all metropolitan Worcester hospitals during 12 annual periods between 1975 and 1999. RESULTS: There was a marked increase in the use of beta-blockers in hospitalized patients between 1975 (11%) and 1999 (82%). Older patients, women, and patients with comorbidities were significantly less likely to be treated with beta-blockers. After controlling for other prognostic factors, patients treated with beta-blockers were less likely to develop heart failure (adjusted odds ratio [OR], 0.58; 95% confidence interval [CI], 0.53-0.63), cardiogenic shock (OR, 0.46; 95% CI, 0.39-0.54), and primary ventricular fibrillation (OR, 0.84; 95% CI, 0.65-1.08) and were less likely to die (OR, 0.26; 95% CI, 0.22-0.29) during hospitalization than were patients who did not receive this therapy. Patients who used beta-blockers during hospitalization had significantly lower death rates after hospital discharge. CONCLUSIONS: The results of this observational study demonstrate encouraging trends in the use of beta-blockers in hospitalized patients with AMI and document the benefits to be gained from this treatment.Source
Arch Intern Med. 2003 Oct 13;163(18):2175-83. Link to article on publisher's siteDOI
10.1001/archinte.163.18.2175Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47165PubMed ID
14557215Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1001/archinte.163.18.2175