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Family Practice, Vol 15, 457-461, Copyright © 1998 by World Organization of Family Doctors

ORIGINAL CLINICAL RESEARCH

Is prophylactic treatment after myocardial infarction evidence-based? [published erratum appears in Fam Pract 1999 Feb;16(1):94]

C Brotons, F Calvo, P Cascant, A Ribera, I Moral and G Permanyer-Miralda
Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.

OBJECTIVE: We aimed to evaluate the use of evidence-based prophylactic treatment after myocardial infarction on hospital discharge and in primary care after 1 year of hospitalization. METHODS AND RESULTS: We conducted a 1-year prospective study of all the patients discharged from a tertiary hospital who had been treated for myocardial infarction from January 1 to December 31 1995. Three hundred and eighty surviving patients were consecutively discharged from the hospital. Seventy per cent of patients were treated with aspirin, 45% with beta-blockers, 27% with calcium channel blockers, 26% with ACE inhibitors, 40% with nitrates and 8% with cholesterol-lowering drugs after discharge from the hospital. In primary care, prescription of lipid-lowering drugs increased to 17%, while prescription of beta-blockers decreased to 34%. ACE inhibitor prescriptions at discharge were clearly more common in patients with impaired ventricular function or heart failure (57%). CONCLUSION: According to the evidence, there is still potential for reducing the risk of a further ischaemic event or death in patients with MI, especially by increasing the use of beta-blockers and lipid- lowering drugs.
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 Fam PractHome page
C. Brotons, G. Permanyer, V. Pacheco, I. Moral, A. Ribera, P. Cascant, and J. Pinar
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