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dc.contributor.authorSilvet, Helme
dc.contributor.authorSpencer, Frederick A.
dc.contributor.authorYarzebski, Jorge L.
dc.contributor.authorLessard, Darleen M.
dc.contributor.authorGore, Joel M.
dc.contributor.authorGoldberg, Robert J.
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:25Z
dc.date.available2022-08-23T17:15:25Z
dc.date.issued2003-10-15
dc.date.submitted2010-05-27
dc.identifier.citationArch Intern Med. 2003 Oct 13;163(18):2175-83. <a href="http://dx.doi.org/10.1001/archinte.163.18.2175">Link to article on publisher's site</a>
dc.identifier.issn0003-9926 (Linking)
dc.identifier.doi10.1001/archinte.163.18.2175
dc.identifier.pmid14557215
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47165
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=14557215&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/archinte.163.18.2175
dc.subjectAdrenergic beta-Antagonists
dc.subjectAged
dc.subjectComorbidity
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMassachusetts
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectMyocardial Infarction
dc.subjectPhysician's Practice Patterns
dc.subjectSurvival Analysis
dc.subjectTreatment Outcome
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleCommunitywide trends in the use and outcomes associated with beta-blockers in patients with acute myocardial infarction: the Worcester Heart Attack Study
dc.typeJournal Article
dc.source.journaltitleArchives of internal medicine
dc.source.volume163
dc.source.issue18
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/313
dc.identifier.contextkey1333066
html.description.abstract<p>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.</p> <p>METHODS: Communitywide study of 10,374 patients hospitalized with confirmed AMI in all metropolitan Worcester hospitals during 12 annual periods between 1975 and 1999.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/313
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages2175-83


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