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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Cardiol
2013 ; 111
(3
): 305-11
Nephropedia Template TP
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English Wikipedia
Temporal trends in medical therapies for ST- and non-ST elevation myocardial
infarction: (from the Atherosclerosis Risk in Communities ARIC Surveillance
Study)
#MMPMID23168284
O'Brien EC
; Rose KM
; Suchindran CM
; Sturmer T
; Chang PP
; Alonso A
; Baggett CD
; Rosamond WD
Am J Cardiol
2013[Feb]; 111
(3
): 305-11
PMID23168284
show ga
Reports from large studies using administrative data sets and event registries
have characterized recent temporal trends and treatment patterns for acute
myocardial infarction. However, few were population based, and fewer examined
differences in patterns of treatment for patients presenting with ST-segment
elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial
infarction (NSTEMI). The aim of this study was to examine 22-year trends in the
use of 10 medical therapies and procedures by STEMI and NSTEMI classification in
30,986 definite or probable myocardial infarctions in the Atherosclerosis Risk in
Communities (ARIC) Community Surveillance Study from 1987 to 2008. Weighted
multivariate Poisson regression, controlling for gender, race and center
classification, age, and Predicting Risk of Death in Cardiac Disease Tool score,
was used to estimate average annual percentage changes in medical therapy use.
From 1987 to 2008, 6,106 hospitalized events (19.7%) were classified as STEMIs
and 20,302 (65.5%) as NSTEMIs. Among patients with STEMIs, increases were noted
in the use of angiotensin-converting enzyme inhibitors (6.4%, 95% confidence
interval [CI] 5.7 to 7.2), antiplatelet agents other than aspirin (5.0%, 95% CI
4.0% to 6.0%), lipid-lowering medications (4.5%, 95% CI 3.1% to 5.8%), ? blockers
(2.7%, 95% CI 2.4% to 3.0%), aspirin (1.2%, 95% CI 1.0% to 1.3%), and heparin
(0.8%, 95% CI 0.4% to 1.3%). Among patients with NSTEMIs, the use of
angiotensin-converting enzyme inhibitors (5.5%, 95% CI 5.0% to 6.1%),
antiplatelet agents other than aspirin (3.7%, 95% CI 2.7% to 4.7%),
lipid-lowering medications (3.0%, 95% CI% 1.9 to 4.1%), ? blockers (4.2%, 95% CI
3.9% to 4.4%), aspirin (1.9%, 95% CI 1.6% to 2.1%), and heparin (1.7%, 95% CI
1.3% to 2.1%) increased. Among patients with STEMIs, decreases in the use of
thrombolytic agents (-7.2%, 95% CI -7.9% to -6.6%) and coronary artery bypass
grafting (-2.4%, 95% CI -3.6% to -1.2%) were observed. Similar increases in
percutaneous coronary intervention and decreases in the use of thrombolytic
agents and coronary artery bypass grafting were noted among all patients. In
conclusion, trends of increasing use of evidence-based therapies were found for
patients with STEMIs and those with NSTEMIs over the past 22 years.
|*Electrocardiography
[MESH]
|*Registries
[MESH]
|Adrenergic beta-Antagonists/*therapeutic use
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Angiotensin-Converting Enzyme Inhibitors/therapeutic use
[MESH]