Use of lipid-lowering medications at discharge in patients with acute myocardial infarction - Data from the National Registry of Myocardial Infarction 3

Background-The present study aimed to assess use of lipid-lowering medicati on at discharge in a current national sample of patients hospitalized with acute myocardial infarction and to evaluate factors associated with prescri bing patterns. Methods and Results-Demographic, procedural, and discharge medication data were collected from 138 001 patients with acute myocardial infarction disch arged from 1470 US hospitals participating in the National Registry of Myoc ardial Infarction 3 from July 1998 to June 1999. Lipid-lowering medications were part of the discharge regimen in 31.7%. Among patients with prior his tory of CAD, revascularization, or diabetes, less than one half of the pati ents were discharged on treatment. In multivariate analysis, factors indepe ndently related to lipid-lowering use included history of hypercholesterole mia (odds ratio [OR] 4.93; 95% CI 4.79 to 5.07), cardiac catheterization du ring hospitalization (OR 1.29; 95% CI 1.24 to 1.34), care provided at a tea ching hospital, (OR 1.26; 95%, CI 1.22 to 1.32), use of beta -blocker (OR 1 .43; 95% CI 1.39 to 1.48), and smoking cessation counseling (OR 1.51; 95% C I 1.44 to 1.59). Lipid-lowering medications were given less often to patien ts who were older (65 to 74 versus <55 years of age; OR 0.82: 95% CI 0.78 t o 0.86), those with a history of hypertension (OR 0.92; 95% CI 0.89 to 0.95 ), and those undergoing coronary artery bypass graft surgery (OR 0.58; 95% CI 0.55 to 0.60). Conclusions-Analysis of current practice patterns for the use of lipid-lowe ring medications in patients hospitalized with acute myocardial infarction reveals that a significant proportion of high-risk patients did not receive treatment at time of discharge.