JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 1998; 32:360-367
© 1998 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Barron, H. V.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Barron, H. V.

CLINICAL STUDIES

Use of angiotensin-converting enzyme inhibitors at discharge in patients with acute myocardial infarction in the United States: data from the National Registry of Myocardial Infarction 2

Hal V. Barron, MD, FACC* {dagger}, Andrew D. Michaels, MD*, Charles Maynard, PhD{ddagger}, Nathan R. Every, MD, MPH{ddagger} for the National Registry of Myocardial Infarction 2 Participants§

* Department of Medicine, Division of Cardiology, University of California–San Francisco Medical Center, San Francisco, California, USA
{dagger} Genentech, Inc., South San Francisco, California, USA
{ddagger} Myocardial Infarction Triage and Intervention (MITI) Coordinating Center, Seattle, Washington, USA

Manuscript received August 12, 1997; revised manuscript received March 30, 1998, accepted April 17, 1998.

Address for correspondence: Dr. Hal V. Barron, Genentech, Inc., 460 Point San Bruno Boulevard, South San Francisco, California 94080-4990
barron{at}ep4.ucsf.edu

Objectives: This study was undertaken to examine recent trends in the use of angiotensin-converting enzyme (ACE) inhibitor therapy in patients discharged after acute myocardial infarction (AMI) and to identify clinical factors associated with ACE inhibitor prescribing patterns.

Background: Clinical trials have demonstrated a significant mortality benefit in patients treated with ACE inhibitors after AMI. Numerous studies have demonstrated underuse of other beneficial treatments for patients with AMI, such as beta-adrenergic blocking agents, aspirin and immediate reperfusion therapy.

Methods: Demographic, procedural and discharge medication data from 190,015 patients with AMI were collected at 1,470 U.S. hospitals participating in the National Registry of Myocardial Infarction 2.

Results: Prescriptions for ACE inhibitor therapy at hospital discharge increased from 25.0% in 1994 to 30.7% in 1996. Patients with a left ventricular ejection fraction ≤40% or evidence of congestive heart failure while in the hospital were discharged with ACE inhibitor treatment 42.6% of the time. Of patients experiencing an anterior wall myocardial infarction and no evidence of heart failure, 26.1% of patients were discharged with this treatment. Of the remaining patients, 15.6% received ACE inhibitors at discharge. ACE inhibitors were prescribed more often to elderly and diabetic patients as well as those requiring intraaortic balloon pump placement. This therapy was given less often to patients who underwent revascularization with coronary angioplasty or coronary artery bypass graft surgery or were treated with calcium channel blocking agents.

Conclusions: Physicians are prescribing ACE inhibitors in patients with myocardial infarction with increasing frequency. Those patients with the greatest expected benefit receive ACE inhibitor treatment most often. However, the majority of even these high risk patients were not discharged with this life-saving therapy.

Abbreviations and Acronyms
  ACC = American College of Cardiology
  ACE = angiotensin-converting enzyme
  AHA = American Heart Association
  AMI = acute myocardial infarction
  CABG = coronary artery bypass graft surgery
  CCP = Cooperative Cardiovascular Project
  ECG = electrocardiographic
  LVEF = left ventricular ejection fraction
  NRMI 2 = National Registry of Myocardial Infarction 2
  PTCA = percutaneous transluminal coronary angioplasty




This article has been cited by other articles:


Home page
Arch Intern MedHome page
A. F. Hernandez, E. J. Velazquez, S. D. Solomon, R. Kilaru, R. Diaz, C. M. O'Connor, G. Ertl, A. P. Maggioni, J.-L. Rouleau, W. van Gilst, et al.
Left Ventricular Assessment in Myocardial Infarction: The VALIANT Registry
Arch Intern Med, October 10, 2005; 165(18): 2162 - 2169.
[Abstract] [Full Text] [PDF]


Home page
JAMAHome page
C. A. Beck, H. Richard, J. V. Tu, and L. Pilote
Administrative Data Feedback for Effective Cardiac Treatment: AFFECT, A Cluster Randomized Trial
JAMA, July 20, 2005; 294(3): 309 - 317.
[Abstract] [Full Text] [PDF]


Home page
Int J Qual Health CareHome page
I. A. Scott, C. P. Denaro, A. C. Hickey, C. Bennett, A. M. Mudge, D. C. Sanders, J. Thiele, and J. L. Flores
Optimising care of acute coronary syndromes in three Australian hospitals
Int. J. Qual. Health Care, August 1, 2004; 16(4): 275 - 284.
[Abstract] [Full Text] [PDF]


Home page
Journal of Pharmacy PracticeHome page
K. M. Field, J. L. Pepin, and M. D. Mehta
Knowing When to Play the Ace: The Use and Under Use of Ace Inhibitors in Primary Practice
Journal of Pharmacy Practice, June 1, 2004; 17(3): 197 - 210.
[Abstract] [PDF]


Home page
ChestHome page
F. Lopez-Jimenez, T. Y. Goraya, J. P. Hellermann, S. J. Jacobsen, G. S. Reeder, S. A. Weston, and V. L. Roger
Measurement of Ejection Fraction After Myocardial Infarction in the Population
Chest, February 1, 2004; 125(2): 397 - 403.
[Abstract] [Full Text] [PDF]


Home page
Cardiovasc ResHome page
D. Jin, S. Takai, M. Yamada, M. Sakaguchi, K. Kamoshita, K. Ishida, Y. Sukenaga, and M. Miyazaki
Impact of chymase inhibitor on cardiac function and survival after myocardial infarction
Cardiovasc Res, November 1, 2003; 60(2): 413 - 420.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. Johnson, Y. Jin, H. Quan, and B. Cujec
Beta-blockers and angiotensin-converting enzyme inhibitors/receptor blockers prescriptions after hospital discharge for heart failure are associated with decreased mortality in Alberta, Canada
J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1438 - 1445.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
J. M. Foody, F. D. Ferdinand, D. Galusha, S. S. Rathore, F. A. Masoudi, E. P. Havranek, D. Nilasena, M. J. Radford, and H. M. Krumholz
Patterns of Secondary Prevention in Older Patients Undergoing Coronary Artery Bypass Grafting During Hospitalization for Acute Myocardial Infarction
Circulation, September 9, 2003; 108(90101): II-24 - 28.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
N Danchin, O Grenier, J Ferrieres, C Cantet, and J-P Cambou
Use of secondary preventive drugs in patients with acute coronary syndromes treated medically or with coronary angioplasty: results from the nationwide French PREVENIR survey
Heart, August 1, 2002; 88(2): 159 - 162.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart J SupplHome page
E.M. Antman and K.M. Fox
Foreword
Eur. Heart J. Suppl., August 1, 2001; 3(suppl_J): J1 - J5.
[PDF]


Home page
CMAJHome page
L. Pilote, F. Lavoie, V. Ho, and M. J. Eisenberg
Changes in the treatment and outcomes of acute myocardial infarction in Quebec, 1988-1995
Can. Med. Assoc. J., July 1, 2000; 163(1): 31 - 36.
[Abstract] [Full Text] [PDF]


Home page
CMAJHome page
A. Dodek
Acute myocardial infarction in Canada: improvement with time
Can. Med. Assoc. J., July 1, 2000; 163(1): 41 - 42.
[Full Text] [PDF]


Home page
Arch Intern MedHome page
R. H. Mehta, T. J. Ruane, P. A. McCargar, K. A. Eagle, and E. J. Stalhandske
The Treatment of Elderly Diabetic Patients With Acute Myocardial Infarction: Insight From Michigan's Cooperative Cardiovascular Project
Arch Intern Med, May 8, 2000; 160(9): 1301 - 1306.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
V. Vaccarino, L. Parsons, N. R. Every, H. V. Barron, H. M. Krumholz, and The National Registry of Myocardial Infarction 2 P
Sex-Based Differences in Early Mortality after Myocardial Infarction
N. Engl. J. Med., July 22, 1999; 341(4): 217 - 225.
[Abstract] [Full Text] [PDF]


Home page
J. Pharmacol. Exp. Ther.Home page
H. P. B.-L. Rocca, D. Weilenmann, W. Kiowski, F. E. Maly, and F. Follath
Plasma Levels of Enalaprilat in Chronic Therapy of Heart Failure: Relationship to Adverse Events
J. Pharmacol. Exp. Ther., April 1, 1999; 289(1): 565 - 571.
[Abstract] [Full Text]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 1998 by the American College of Cardiology Foundation.