Are We Optimizing the Use of Dual Antiplatelet Therapy in Patients Hospitalized with Acute Myocardial Infarction?
Autor: | Darleen M. Lessard, Robert J. Goldberg, Essa Hariri, Joel M. Gore, Jeffrey J. Rade |
---|---|
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Time Factors animal structures Prasugrel medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Drug Prescriptions Risk Assessment Article 03 medical and health sciences Coronary artery bypass surgery 0302 clinical medicine Risk Factors Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine Myocardial infarction Healthcare Disparities Practice Patterns Physicians' Aged Cardiac catheterization Aged 80 and over Aspirin business.industry Dual Anti-Platelet Therapy General Medicine Odds ratio Middle Aged medicine.disease Clopidogrel Drug Utilization Hospitalization Treatment Outcome Massachusetts Conventional PCI Purinergic P2Y Receptor Antagonists Female Cardiology and Cardiovascular Medicine business Prasugrel Hydrochloride Platelet Aggregation Inhibitors medicine.drug |
Zdroj: | Cardiovasc Revasc Med |
ISSN: | 1553-8389 |
Popis: | Background Dual antiplatelet therapy (DAPT) is a mainstay treatment for hospital survivors of an acute myocardial infarction (AMI). However, there are limited data on the prescribing patterns of DAPT among patients hospitalized with AMI during recent years. Objective To examine decade-long trends (2001−2011) in the use of DAPT versus antiplatelet monotherapy and patient characteristics associated with DAPT use. Methods The study population consisted of 2389 adults hospitalized with an initial AMI at all 11 central Massachusetts medical centers on a biennial basis between 2001 and 2011. DAPT was defined as the discharge use of aspirin plus either clopidogrel or prasugrel. Logistic regression analysis was used to identify patient characteristics associated with DAPT use. Results The average age of the study population was 65 years, and 69% of patients were discharged on DAPT. The use of DAPT at the time of hospital discharge increased from 49% in 2001 to 74% in 2011; this increasing trend was seen across all age groups, both sexes, types of AMI, and in those who underwent a PCI. After multivariable adjustment, patients 65–74 years old (adjusted odds ratio (aOR) = 0.53, 95% CI: 0.36–0.80) and those who underwent coronary artery bypass surgery (aOR = 0.11, 95% CI: 0.07–0.18) were less likely to have received DAPT, while men (aOR = 14.60, 95% CI: 10.66–19.98) and those who underwent cardiac catheterization and stenting (aOR = 14.60, 95% CI: 10.66–19.98) were significantly more likely to have received DAPT at discharge than respective comparison groups. Conclusions Between 2001 and 2011, the use of DAPT increased markedly among patients hospitalized with AMI. However, a significant proportion of patients were not discharged on this therapy. Greater awareness is needed to incorporate DAPT into the management of patients hospitalized with AMI. |
Databáze: | OpenAIRE |
Externí odkaz: |