Trends and outcomes associated with angiotensin-converting enzyme inhibitors
AuthorsDoubeni, Chyke A.
Lessard, Darleen M.
Spencer, Frederick A.
Yarzebski, Jorge L.
Gore, Joel M.
Gurwitz, Jerry H.
Goldberg, Robert J.
UMass Chan AffiliationsDepartment of Family Medicine and Community Health
Department of Medicine, Division of Geriatric Medicine
Meyers Primary Care Institute
Department of Quantitative Health Sciences
Department of Medicine, Division of Cardiovascular Medicine
Document TypeJournal Article
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors
Health Services Research
MetadataShow full item record
AbstractBACKGROUND: Limited recent data are available describing the patterns of use of angiotensin converting enzyme inhibitor (ACEI) therapy in patients with acute myocardial infarction (AMI), particularly from the more generalizable population-based setting. The purpose of this study was to examine trends in the receipt of ACEIs and associated short-term outcomes in patients hospitalized with AMI in a large Northeastern community. METHODS: We conducted a community-wide study of 7991 patients hospitalized with AMI in all metropolitan Worcester, Massachusetts, medical centers during 8 annual periods between 1990 and 2003. RESULTS: Among all patients, 44% received ACEI therapy during their acute hospitalization. There was a marked increase in the use of ACEIs between 1990 (23%) and 2003 (68%), particularly among those who were not on ACEIs before hospitalization. Patients who were previously on ACEIs were more likely to receive this therapy during hospitalization for AMI than were patients who were not previously on this therapy. Patients treated with ACEIs were significantly less likely to die (adjusted odds ratio [OR] 0.33; 95% confidence interval [CI] 0.27-0.41) during hospitalization than were patients who did not receive this therapy, with benefits observed across all subgroups examined. CONCLUSIONS: The results of this observational study demonstrate marked increases in the use of ACEIs in patients with AMI in the community setting and demonstrate the benefits to be gained from use of this therapy. Despite these encouraging trends, there remains room for more optimal use of this therapy.
SourceAm J Med. 2006 Jul;119(7):616.e9-16. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/47641
Related ResourcesLink to Article in PubMed