Decade-long trends (1986 to 1997) in the medical treatment of patients with acute myocardial infarction: A community-wide perspective

Background Although there are an increasing number and variety of medicatio ns available for the treatment of patients with acute myocardial infarction (AMI), few data are available describing recent, and changes over time in, use of different cardiac medications in patients with AMI from a more gene ralizable, community-wide perspective. Moreover, it is unclear whether the demographic and clinical profile of patients receiving these agents is simi lar or varies according to the type of agent prescribed. Methods and Results The purpose of this study was to examine recent pattern s and changes over a decade-long period (1986 to 1997) in the use of cardia c medications during the acute hospitalization and at the time of hospital discharge in metropolitan Worcester, Mass, residents (1990 census estimate, 437,000) hospitalized with confirmed AML There was a marked increase in th e use of angiotensin-converting enzyme inhibitors, aspirin, P-blockers, lip id-lowering agents, and thrombolytic therapy between 1986 and 1997. The use of calcium antagonists, lidocaine, and other antiarrhythmic agents decline d over this period. Similar trends were observed in the use of these agents in hospital survivors at the time of hospital discharge. Patient age, pres ence of comorbidities, and AMI-associated characteristics influenced the us e of these therapies; sex differences in the use of several of these medica tions were also noted. Conclusions The results of this population-based observational study provid e insights into changing prescribing patterns in the hospital treatment of patients with AMI. Despite encouraging increases in the use of several of t hese agents, considerable opportunities for increased utilization remain.