Communitywide trends in the use and outcomes associated with beta-blockers in patients with acute myocardial infarction: the Worcester Heart Attack Study
dc.contributor.author | Silvet, Helme | |
dc.contributor.author | Spencer, Frederick A. | |
dc.contributor.author | Yarzebski, Jorge L. | |
dc.contributor.author | Lessard, Darleen M. | |
dc.contributor.author | Gore, Joel M. | |
dc.contributor.author | Goldberg, Robert J. | |
dc.date | 2022-08-11T08:10:39.000 | |
dc.date.accessioned | 2022-08-23T17:15:25Z | |
dc.date.available | 2022-08-23T17:15:25Z | |
dc.date.issued | 2003-10-15 | |
dc.date.submitted | 2010-05-27 | |
dc.identifier.citation | Arch 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.issn | 0003-9926 (Linking) | |
dc.identifier.doi | 10.1001/archinte.163.18.2175 | |
dc.identifier.pmid | 14557215 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/47165 | |
dc.description.abstract | 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. | |
dc.language.iso | en_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.url | http://dx.doi.org/10.1001/archinte.163.18.2175 | |
dc.subject | Adrenergic beta-Antagonists | |
dc.subject | Aged | |
dc.subject | Comorbidity | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Massachusetts | |
dc.subject | Middle Aged | |
dc.subject | Multivariate Analysis | |
dc.subject | Myocardial Infarction | |
dc.subject | Physician's Practice Patterns | |
dc.subject | Survival Analysis | |
dc.subject | Treatment Outcome | |
dc.subject | Bioinformatics | |
dc.subject | Biostatistics | |
dc.subject | Epidemiology | |
dc.subject | Health Services Research | |
dc.title | Communitywide trends in the use and outcomes associated with beta-blockers in patients with acute myocardial infarction: the Worcester Heart Attack Study | |
dc.type | Journal Article | |
dc.source.journaltitle | Archives of internal medicine | |
dc.source.volume | 163 | |
dc.source.issue | 18 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/qhs_pp/313 | |
dc.identifier.contextkey | 1333066 | |
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.submissionpath | qhs_pp/313 | |
dc.contributor.department | Department of Medicine, Division of Cardiovascular Medicine | |
dc.source.pages | 2175-83 |