Patterns of prescribing ACE inhibitors after myocardial infarction

We attempted to determine physician prescribing patterns of angiotensin-con verting enzyme (ACE) inhibitors in patients who experienced a myocardial in farction, stratified by left ventricular function. We retrospectively revie wed drug therapy at discharge in 534 patients to assess prescription of ACE inhibitor therapy, including dosage. Thirty-four percent of patients were discharged taking an ACE inhibitor, of whom only 11% received recommended d osages. The drugs were prescribed more often for patients who had an ejecti on fraction below 40% than for those with an ejection fraction of 40% or ab ove (54% vs 28%, p<0.05). We conclude that ACE inhibitors are underprescrib ed for patients who experienced a myocardial infarction, illustrating the g ap between clinical research and clinical practice, and the need for progra ms to ensure optimal medical management.